Please fill out and submit this form to us via our website or through land mail to receive your user name and password.

Privacy Statement: We do not sell client information.

Your information will only be used for sending you info via e-mail, our printed company brochure if you do not check the "no brochure" check box, and occasional product update e-mail messages. You can ask to be removed from our list at any time and we do not sell, rent or otherwise distribute any information that you provide to us.
To sign up for wholesale information you can :
· click the submit button to send us the information via e-mail,
· send us the information via e-mail at quiltcomfort(at)quilterscomfort.net
· mail your completed form to Quilter's Comfort Tea - P. O. Box 8172, Drawer B, Bloomington, IN 47407
Please include your resale/UBI number. For wholesale sales, we only sell business-to-business. We will not be able to send you information about our products without a UBI.

Please note that prices are subject to change due to changing costs. All current customers will be notified as changes occur. Changes in prices will be posted to our website.

Company Information and Billing Address:
Contact Person:
Contact Person's Phone Number:
Contact Person's Email Address:
Company Name:
Address:
City:
State/Province:
Other State/Province:
Zip/Postal Code:
Country:
UBI/Resale Number:
Company Phone Number (if different):
Fax Number:
Company Web Site:
How Did You Hear About Us?

Shipping Address (If Different):
Address:
City:
State/Province:
Other State/Province:
Zip/Postal Code:
Country:
Contact Preferences:
Send me a printed brochure with product information and wholesale policies. ___ Y or __ N
Add me to your e-mail list for occasional notifications of new products and policies.

___ Y or __ N