Please complete the questionnaire below. Please understand that with the volume of new dealer requests, it takes time to thoroughly evaluate each application. Allow a minimum of three business days for a response from the MIX team.

Your Name

Your Email

Preferred Username

Your Company Name

Resale Certificate

Business Type: (required)

Brick-and-Mortar Store:Interior Designer:Multifamily:Other:

Years in Business:

Street Address

City / State / Zip

Phone

Website Address

How did you hear about us?

What are your current top selling contemporary brands?

Which categories of products are you most interested in selling (brick-and-mortar store only)

Bar and DiningOccasionalOutdoor Living

How much do you sell per year on each category above?

How do you plan on selling and promoting our brand?

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Yes