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Wholesale Customer Intake Form

     Thank you for your interest in buying wholesale from Yoga Life Style. Everything on the site is available at competetive discounts for quantity buyers. Just tell us a little about your self or your organization and we will enable your user name and password to be used to access our wholesale pricing information online and place wholesale orders. Please fill in the form below and choose your user name and password.
We should enable it within 48 hours.
Thanks,
Ray

Full Name:
Company Name:
Email Address:
Telephone:
Address:
City:
State/Province:
Postal Code:
Country:

Please Tell us a bit about your business.

Pick Your User Name:	(One continuous sequence of letters and/or numbers please. Our system will not accept spaces. Example: JaiMa2 is OK. Jai Ma 2 or Jai_Ma_2 is not.)
Pick Your Password:	(Same instructions as above)

Go to pricing (use this only if you have an enabled user name and password already, otherwise submit form for future access.)

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Yoga Life Style
116 Costa Road
Highland, NY 12528
845.883.4220

email: info@YogaLifeStyle.com

www.YogaLifeStyle.com © 2003