Wholesale Customer Intake

Home 9 Wholesale Customer Intake

Wholesale Customer Intake

Complete the form below to apply for a Vine Bar wholesale account. Once approved, you’ll be able to place wine orders by text message and receive automated order confirmations. A member of our team will follow up within 1–2 business days.

Wholesale Intake

Company

This field is for validation purposes and should be left unchanged.

Business Name(Required)

Contact Person(Required)

Your Role/Title

Default Delivery Person / Receiving Contact

Mobile Number(Required)

Email(Required)

Delivery Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Delivery Instructions

SMS Odering

Mobile Number for SMS Ordering(Required)

Signature(Required)