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International Retailer Application

children wearing pediped footwear

Thank you for your interest in pediped® footwear. pediped® does not currently accept applications from consignment stores or stores that sell used goods.

Please take a few minutes and fill out this online application.  You will be notified once you are approved.

If you have any questions regarding the status of your application, please contact

* First Name:   * Last Name:  
* Store Name:   * VAT#:  
  All international accounts require a VAT number.  If you do not have a number
please type N/A and explain why in the box below:
* Email:     * Confirm Email:    
Website URL:
* Phone #:   Fax #:

Mailing Address
* Address:  
* Country:  
Store Address
* Address:  
* Country:  

* Type of Retailer:  
* Specialty:       
* Merchandise:
* Price Range of Merchandise:  
Describe your store
* Location:  
* Clientele:  
* Décor:  
* Size (sqm):  
Other Details:  
The more you can describe your store in detail, the better it will assist us in approving your application.
* Is your store currently open?   * If yes, how many years has it been established?  

* How many
(brick & mortar) store locations do you have?

Name 3 brands that you carry or plan to carry.
* Brand 1:  
* Brand 2:  
* Brand 3:  
* Other Brands:
How did you hear about us?
Trade Magazine (s):

Consumer Magazine (s):
Trade Show:

Comments or

By submitting this application, you agree that you have read our wholesale policy and agree to the terms outlined. Customers who sell below MSRP or auction sites, such as ebay will not be shipped again. Click here to read our wholesale policy.