Thank you for your interest in Khan Imports. To request a Wholesale Price List,
please print this form, complete and return by fax (805) 967-7128, or mail to:
Khan Imports 5730 Encina Rd., Suite 1, Goleta, CA 93117-6250
A copy of your Seller's Permit, Resale Certificate, or Tax I.D. is required,
and must be included with this form for your request to be processed.
||_________________ Home: ______________|
|Name / Title:
|1. Please select the type of business. (Check all that apply.)|
|____ Department Store
||____ E-commerce Site|
|____ Executive Gifts
||____ General Gift
||____ Interior Design|
||____ Museum Shop
||____ Nature Store|
|____ New Age
||____ New Business
|2. How long has this store been open?|
|____ Store is not open yet. (Please also indicate when store will open.)|
|____ 0 - 3 Months
||____ 3 - 6 Months
||____ 6 - 12 Months|
|____ 1 - 2 Years
||____ 2 - 5 Years
||____ Over 5 years|
|3. Does this business have a website?|
|____ Yes, site address listed above.
||____ No, we don't have a website.|
|____ Yes, site is under construction.
||____ No, we're thinking about it.|
|4. Does this business have a "physical" retail storefront location?|
|____ Yes, I listed the location above.|
|____ Yes, we have a location but have not opened yet.|
|____ Not at this time, we're thinking about it.|
|____ No, we retail through our website.|
|Other Method of Retailing: (Please specify.)|
|5. Does this business directly import any of it's own products?|
|____ No, we do not import.||____ No, we're thinking about it.|
|Yes, we are currently or have imported from the following countries:|
| _______________ _______________ ______________|
|6. Please describe the "physical" location of this store.|
|(Example: Shopping Mall or Center, Main St., Downtown, Tourist Area,|
Show Booth, Kiosk, Fairs or Festivals, Home Based, etc.)
|7. I am interested in the following product types:|
|____ All Product Types
||____ Bookends & Pencil Holders|
|____ Vases & Planters
||____ Desk & Shelf Clocks|
|____ Bowls, Trays, Wine Glasses||____ Boxes, Jars & Canisters|
|____ Mortar & Pestle Sets
||____ Decorative Spheres & Obelisks|
|____ Drink Coaster Sets||____ Animal Figurines & Sculptures|
|8. I would like to request the following: (Check all that apply.)|
|Please reference our online catalog for initial orders.|
|____ Please e-mail me a link to your "printable" Wholesale Price List.|
|____ Please notify me by e-mail of special wholesale offers.|
|____ Please rush my request, I am interested in placing an order.|
9. Please sign this form prior to submission. Thank you.
I declare that all information provided on this form is correct and true.
I agree that any pieces purchased from Khan Imports will not be marketed, presented or sold on the Internet (websites, auction sites, etc.) in any way.
Signature __________________________ Date: ____________
All information provided is kept strictly confidential.
Please include a copy of your Seller's Permit, Resale Certificate, or Tax I.D.
Toll Free: 800-260-1064 Tel. 805-967-8050 Fax: 805-967-7128
Monday - Friday, 8:00AM - 4:00PM (Pacific Time)
5730 Encina Rd., Suite 1
Goleta, CA 93117-6250
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