Wholesale Application Form

Thank you for your interest in Samovar’s Wholesale Program. To apply, please fill out the below form (all fields are required).

Your Contact Information


Your Business Information


Other:


Other:

 Bulk tea Tea Boxes Tea Ware


Account Setup Information

Have you ordered Online with us before?
If so, we can convert that account to place wholesale orders:

 Yes


Terms (*required)

I have read and agree to the Terms of Sale.

I agree to reference the brand Samovar Tea as my tea supplier on my menu, or by displaying a Samovar logo plaque in my store.

AUTHORIZATION: The undersigned is giving Samovar Tea Lounge, California authorization to contact your credit references. Also, the undersigned will authorize Samovar Tea Lounge to charge the credit card listed above on their first two (2) orders. Accounts past due over 14 days will be automatically charged on the listed credit card above.