Contact Information

First Name *

Last Name *

Business Phone *

Business Email *

Business Details

Business Name *

Which best describes you? *

Business Website *

Enter your social media page (Instagram, Facebook, etc.) if you don’t have a website.

Business Billing Address

Country *

Address Line 1 *

Address Line 2 (Optional)

City *

State / Province *

Postal Code *

Form ID

Product Selection

Search and select your products. Specify color, size/style if applicable, and quantity. You may add up to 5 products per trade purchase request.

Product 1 *

Color

Size / Style

Quantity *

Product 2 (Optional)

Color

Size / Style

Quantity

Product 3 (Optional)

Color

Size / Style

Quantity

Product 4 (Optional)

Color

Size / Style

Quantity

Product 5 (Optional)

Color

Size / Style

Quantity

Delivery Deadline (Optional)

If you have a required delivery deadline, enter it below, and we’ll choose the most cost-effective shipping method to meet it. Leave this blank if you have no deadline and prefer the most economical quote.

Recipient Contact Information

Recipient First Name *

Recipient Last Name *

Recipient Phone Number *

Recipient Email *

Delivery Address

Country *

Address Line 1 *

Address Line 2 (Optional)

City *

State / Province *

Postal Code *

Submit Your Request

How did you hear about us?

I agree to be contacted by Ellure regarding this order request and agree to the Terms of Service and Privacy Policy. *

Betten &amp; Kopfteile

Betten & Kopfteile