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Complete online Dealer Application

Dealer Application

You must be authorized as a retail business to receive "Dealer" status. We require Resale Tax information, Trade References and the submission of our Dealer application. Lillian Rose does not sell to the public. Please see our "Store Near You" section of our site if you are a consumer looking to purchase our products. We sell only to Authorized Retail Dealers. Complete this Dealer Application Form, if you are a retail business that would like to purchase our products for resale. (If selling On-Line, a separate Website Guidelines form must be completed)

You may be asked to fax or mail copies of business documents to support your application.

This Dealer Application Form must be completed by an Authorized Officer of your company of legal age. This information is received in confidence and will not be used for any other purpose. We do not provide this information to any third party.

When we have processed the application and recognized your firm as a Lillian Rose Reseller, we will issue you a user name and password to access the wholesale portion of the Lillian Rose site.

Current Dealers of Lillian Rose can contact us at (800) 521-8760 or (262) 363-5286 to receive a user name and password.

Fields marked with * are required.

An applicant may enter one Ship To address when submitting your application. If your application is approved, and your online account established, you will be able to enter multiple shipping locations in your profile. When ordering, you will be able to select which shipping location the order is going to.

Bill To


Ship To


General Information

Propriatorship     Partnership     Corporation    
Commercial     Residential    

Are you interested in the following:

By submitting this application, I agree to the following Terms and Conditions of this Dealer Application: I acknowledge that this application is submitted for the purpose of establishing myself as a dealer for products sold by Lillian Rose. I acknowledge that if I am an on-line dealer I must still complete and abide by the Lillian Rose Website Guidelines (separate form). Applicant is a legitimate retail business with a store front and/or retail website and resale tax ID number. All answers are true and complete to the best of my knowledge.