nomadic state of mind

Please fill out the following Reseller Application to become an authorized reseller of Nomadic State of Mind products.


Business Name:

Street Address:

City, State, Zip Code

Legal Owner:

Bill To Address: (if different from above)

Street Address:

City, State, Zip Code

Telephone Number

Fax Number:

Email Address:


Type of Store

Federal Tax ID#

Reseller Permit #

Date Store Started?

List any other selling locations (if any)

Why do you want to sell our products at your location?

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All Rights Reserved. Unauthorized reproduction of any material in part or whole is prohibited.

there are those who wander, those who follow and and those who ARE