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Retailer Application

First Name
Last Name
Title
Email *
   
Phone # *
   
Fax #
Store Name
Website URL
Mailing Address
Street Address
City
State/Province
Zip/Postal Code
Country
Store Address
Street Address
City
State/Province
Zip/Postal Code
Country
Describe your store
Years established
How many locations
Other brands carried
Federal Tax ID#
VAT#
How did you hear about us?
Comments or Questions

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.

Please contact us or fill in the online application

Wholesale Contacts

Europe, Asia, Middle East, South America,
Africa, Distributors

Rudy Glocker
917-297-4054
rudy@pediped.com

Eastern United States/Eastern Canada
Mike McCaffrey
Phone: 201-602-0663
michael@pediped.com

United Kingdom/Ireland
+07703 856072
matt@pediped.com

Western United States/ New England/
Western Canada /AK/HI/Puerto Rico

Dan Lawlor
Phone: 717-514-5078
dan@pediped.com

Australia
Betty Ristevski
+61 0412 520 868
betty@pediped.com