WHOLESALE CUSTOMER APPLICATION

Please use this application form when applying for wholesale discounts. This form may be mailed or faxed to our office at the numbers located below and we will create your customer profile to reflect the discounted pricing. Your wholesale orders must be placed via fax or e-mail and not through our website as it is not set up to recognize those prices. Once we receive this application, we will e-mail you with our Wholesale Price List. PLEASE NOTE: WHOLESALE CUSTOMERS ARE REQUIRED TO MAINTAIN MINIUMUM PRODUCT PURCHASES OF $200.00 PER ORDER (AT THE WHOLESALE PRICES) TO QUALIFY FOR WHOLESALE DISCOUNT PRICES.

Merchandise is discounted at 30% off the retail price.
Retail pricing can be found at www.viable-herbal.com.

P.O. Box 1025 • Langhorne, PA 19047 • Ph: (866) 437-3122 • Fax: (866) 437-3124
E-mail: customerservice@viable-herbal.com • Business Hours: 8:00 am to 5:00 pm (EST)
Business Name: EIN#:
Billing Information
Shipping Information
Name On Card:   Name:  
Complete
Address
(where
credit card
bill is sent):

 

 

 

 Complete
Address:		  
Phone #:   E-mail:  
Card Type:
(circle one)
Visa       Mastercard       Discover       American Express
Expiration Date:
 
Card #:
 
*3- or 4-Digit
Card Code:
 
Signature:
   * Visa, Mastercard, and Discover have a 3-digit number on the back of the card, and American Express has a 4-digit number on the front for security purposes.
Check or
Money Orders:
If using this payment method, you must fax or e-mail your order so that we can produce a shipping quote. After we respond to you with the shipping quote, please make your check or money order payable to Viable Herbal Solutions and mail it to the address above. Please include your order number with your check so that we can easily apply the payment. We accept U.S. funds only. Your order will be held until payment is received.

Customer Comments:

 

 
Shipping Methods
To the right are the shipping methods we offer. We do not offer COD. Your order size will determine shipping and handling costs. If you wish to know the actual shipment costs prior to shipment, please be sure to tell us when you place your order and we will have a representative contact you with the amount before the order ships.
 Standard Shipping: USPS Priority Mail (US ONLY)
 UPS 3-Day: (US ONLY)
 UPS Second Day Air: (US ONLY)
 UPS Overnight: (US ONLY)
 UPS Saturday Delivery: (US ONLY)
 International: USPS Global Express Guaranteed
 International: USPS Priority Mail International
Thank you for doing business with Viable Herbal Solutions!