Chica Rica Bikini Company

Wholesale Application


* Company:			How long have you been in business:
* Contact:
Address 1:			What clothing/swimsuit lines are currently sold in your store?
Address 2:
City:
* State/Province:			What other clothing/accessory lines do you carry?
Zip/Postal Code:
* Country:
Tel:			Your CO. TAX ID or Resale Number:
Fax:			How did you hear about Chica Rica Bikini Company?
Email:			How did you hear about Chica Rica Bikini Company?
Website:
* REQUIRED

Chica Rica Bikini Company
650 West 18 St.
Hialeah, FL 33010

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