Copperfield New Wholesale Partner

Interested in becoming a new Copperfield Wholesale Partner? Simpliy fill out the form below and our New Partner team will get you set up! If you have any questions, call us at 570-504-7165 or send us an email.

If you already have an account, click here to login.

Business Information

Company Name*

Business Type*

Tax ID #*

Primary Business*

Website URL*

Parent Website

Sub Website

Business Contacts

Contact information in for the owner of the company.

Owner First Name*

Owner Last Name*

Owner Phone*

Owner Email*

Contact information in for the sales/account manager lead in the company.

Sales/Account Manager First Name

Sales/Account Manager Last Name

Sales/Account Manager Phone

Sales/Account Email

Contact information in for the accounts/payables lead in the company.

Accounts/Payables Contact First Name*

Accounts/Payables Contact Last Name

Accounts/Payables Contact Phone*

Accounts/Payables Contact Email*

Contact information in for any other important contact in the company if appropriate.

Other Contact Point First Name

Other Contact Point Last Name

Other Contact Point Phone

Other Contact Point Email

Address Information

The official location of a business.

Business Address

Business Address 2*

Business City*

Business State*

Business Postal Code*

How long have you been at this address?

The address where products, supplies, and other physical items are sent.

Shipping Address*

Shipping Address 2*

Shipping City*

Shipping State*

Shipping Postal Code*

Business Verification

Please select and upload one of the documents listed below for business verification and our records.

Business Verification*

Business Verification Upload*