Date:

Contact:

Store Name:

Address:

City, State Zip:

# of location:

Phone:

Fax:

Email:

Are you carrying other European luxury
home collections?

If yes, please list:

How did you hear about Bellora?

Press:

Trade Shows:

Other Retailer:

Other:

What is your combined annual sales
volume for bedding, bath, table and
kitchen textiles?

less than $100,000

less than $500,000

less than $1,000,000

more than $1,000,000

Departments in the store:

Bedding

Bath

Tabletop

Kitchen

Fragrances

Accessories

What is the size of your store?

less than 1000 sq/ft

between 1,000 - 3,000 sq/ft

over 3,000 sq/ft

How many bed displays do you have?

less than three

less than six

more than six

Will you order prepacked quantities for a better discount?

yes

no

What is your policy in case of incomplete orders availability?

call

accept

do not accept

Would you consider a shop in the shop?

yes

no