Retailer Inquiry Form

If your interested in being an authorized dealer of the Denise Cox Collections please submit the form below.

Are you a brick and mortar store?*
- Yes
- No
Store Name*
Store Contact*
First Last
Store Phone Number*
Store Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Tax ID#*
Store Website*
Current brands carried in store*
Photos of the interior and exterior of your store*

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