Affiliate Registration Form If you already have an account, please log in before filling out the form. If you are interested in becoming one of our valued Wholesale Customers, we invite you to complete the Application Form. We offer local delivery (I-5 corridor, Eugene, OR to Seattle, WA) on our trucks with a 24 flat minimum with a delivery fee. Outside our local delivery area we palletize and ship via common carrier. We can get up to 50 flats on a pallet. Shipping rates apply, free shipping only available for retail customers. If you already have an account with us, please Log in before completing this application We will review your application and get back to you as soon as possible. We look forward to having you on board with Little Prince! Garden Center 911 is intended to be a positive stimulus to the Horticulture industry in a time of uncertainty and turmoil. This is uncharted territory for all of us. Thank you for being patient as we work out any kinks in this program. While we do not guarantee its success, we believe strongly that this program will positively affect participating Garden Centers bottom line. Together, we thrive!Company InfoCompany Name* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Shipping Address* Use billing address for shipping Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Type*Garden CenterLandscaperOther (Please specify)Business Type (Other)* Website Primary ContactName* First Last Title Email* Enter Email Confirm Email Phone*How did you hear of us?Web SearchExisting CustomerAdvertisementTrade ShowFacebookNewsletterPress ReleaseLocal NewsOtherOther (please specify) Tax and PaymentA Paypal account is required. If you do not have one, Sign up for one before continuing. Please download the W-9 form, then click "Choose FIle" to upload the completed form. If you'd prefer to send us the form via Fax, check the "I will fax my completed W-9" box and fax your form to {lpo_fax_number}. Tax Identification Number/SSN* Paypal Email* Completed W-9*Accepted file types: pdf, Max. file size: 64 MB. I will fax my completed W-9 Terms of Service* I agree to the terms of serviceIf you sign-up for a Little Prince Affiliate account, and later wish to opt out, simply notify Little Prince via Email, and we will remove access to our online store for your customers. Direct Emails to [email protected] We guarantee the quality of our plants, and all returns and requests for replacements will be handled by Little Prince. Return Policy: If you’re not happy, we’re not happy! Please email [email protected] for a remedy within 2 weeks of delivery. We are happy to offer a refund or replacement of plants (if available). Funds will be deposited into Garden Centers funding accounts within 3 weeks of the sale. PhoneThis field is for validation purposes and should be left unchanged. Δ
