If you want to offer your customers the Black HIlls Gold brand consumers choose most often along with frequent new styling to keep your customers coming back for more, then simply complete the Retailer Registration Form.  Once approved, you will gain access to the Retailer Login section to review our terms and pricing and to complete our Account Application.

With your Account Application, we look forward to your $250 opening order.  Therafter, we look for a $100 reorder.  Once your account exceeds $1,500 in purchases in one year, the $100 reorder is waived.

Contact Information (Required)


Name
 

Company Name

 
Mailing Address 


Company Phone Number 

Company Fax Number
 

 
Company Email Address 


Company Web Site

 
Company State Sales Tax ID.  (Oregon and Montana please use Federal Tax ID)

How did you learn about Black Hills Gold Jewelry by Coleman?

Company Background (Required)

What type of store(s) do you operate? 

Do you currently carry or have your carried Coleman Black Hills Gold Jewelry? 

Do you plan to stock Coleman Black Hills Gold Jewelry? 

How much Black Hills Gold Jewelry do you plan to stock? 

Please indicate your preferred shipping method.  

Please select your preferred method of ordering.  

Please select your shipping insurance preference.  

Please indicate your estimated markup. 

Information Disclosure

 Black Hills Gold Jewelry by Coleman reserves the right to analyze this form to evaluate and screen interested retailers. From this evaluation and screening, Black Hills Gold Jewelry by Coleman will determine if a working business relationship is possible. Please note that the information listed is considered confidential and will not be forwarded to any solicitors or any third-member parties.