{"id":368,"date":"2015-05-03T03:37:02","date_gmt":"2015-05-03T03:37:02","guid":{"rendered":"https:\/\/www.haenow.com\/content\/?page_id=368"},"modified":"2023-05-27T16:43:35","modified_gmt":"2023-05-27T16:43:35","slug":"request-a-wholesale-account","status":"publish","type":"page","link":"https:\/\/www.haenow.com\/content\/customers\/request-a-wholesale-account\/","title":{"rendered":"Register for Wholesale"},"content":{"rendered":"<div class=\"row\">\n<div class=\"col-md-12\"><b>Thank you for your interest in HAE Now&#8217;s fair trade organic cotton products.<\/b><br \/>\nTo establish a wholesale account for your business please submit the form below. If sufficient qualifying information is provided, access to our wholesale pricing and online ordering is usually granted within a few business hours.<br \/>\n<small><strong>Note: <\/strong>If you have an approved wholesale account and forgot your password please click here to <a href=\"forgotten-password\">Request New Password<\/a>.<\/small><\/div>\n<\/div>\n<form class=\"form-horizontal haenow ng-cloak\" name=\"myform\" data-ng-controller=\"RequestAccountController\">\n<div class=\"form-group\">\n<h3 class=\"has-error\" data-ng-show=\"submitted &amp;&amp; (myform.$invalid || $scope.invalid)\">You have missed some required fields.<\/h3>\n<p><label for=\"input_company\" class=\"col-sm-3 control-label\">Name of company:<sup>*<\/sup><\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_company\" data-ng-model=\"mymodel.company\" placeholder=\"company\" name=\"company\" required=\"\" data-ng-class=\"{ 'has-error' : submitted &amp;&amp; myform.company.$error.required }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_name\" class=\"col-sm-3 control-label\">Your name:<sup>*<\/sup><\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_name\" data-ng-model=\"mymodel.name\" placeholder=\"name\" name=\"name\" required=\"\" data-ng-class=\"{ 'has-error' : submitted &amp;&amp; myform.name.$error.required }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_title\" class=\"col-sm-3 control-label\">Your job title:<\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_title\" data-ng-model=\"mymodel.title\" placeholder=\"title\" name=\"title\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_phone\" class=\"col-sm-3 control-label\">Phone #:<sup>*<\/sup> <\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_phone\" data-ng-model=\"mymodel.phone\" placeholder=\"phone\" name=\"phone\" required=\"\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; myform.phone.$error.required }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_email\" class=\"col-sm-3 control-label\">Email:<sup>*<\/sup><\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"email\" class=\"form-control\" id=\"input_email\" data-ng-model=\"mymodel.email\" placeholder=\"email\" name=\"email\" required=\"\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; (myform.email.$error.required || myform.email.$invalid) }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_usa\" class=\"col-sm-3 control-label\">Location:<sup>*<\/sup><\/label><\/p>\n<div class=\"col-sm-8 col-md-8\"><input type=\"radio\" id=\"input_usa\" value=\"usa\" data-ng-model=\"mymodel.usa\" checked=\"checked\" data-ng-change=\"mymodel.country_id = 223;mymodel.state = ''\" kl_vkbd_parsed=\"true\"> USA<br \/>\n<input type=\"radio\" id=\"input_out_usa\" value=\"out_usa\" data-ng-model=\"mymodel.usa\" data-ng-change=\"mymodel.state = 'INT';mymodel.country_id = ''\" kl_vkbd_parsed=\"true\"> Outside USA<\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_address1\" class=\"col-sm-3 control-label\">Address: <sup>*<\/sup><\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_address1\" data-ng-model=\"mymodel.address1\" name=\"address1\" placeholder=\"address1\" required=\"\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; (myform.address1.$error.required || myform.address1.$invalid) }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\"><label for=\"input_address2\" class=\"col-sm-3 control-label\">Address:<\/label><\/p>\n<div class=\"col-sm-5 col-md-4\"><input type=\"text\" class=\"form-control\" id=\"input_address2\" data-ng-model=\"mymodel.address2\" placeholder=\"address2\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"row form-group\">\n<div class=\"col-md-3\"><label for=\"input_city\" class=\"control-label\">City:<sup>*<\/sup> <\/label><br \/>\n<input type=\"text\" class=\"form-control\" id=\"input_city\" data-ng-model=\"mymodel.city\" placeholder=\"city\" name=\"city\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; mymodel.city == '' &amp;&amp; mymodel.province =='' }\" kl_vkbd_parsed=\"true\"><\/div>\n<div class=\"col-md-3\" data-ng-show=\"mymodel.usa == 'out_usa'\"><label for=\"input_province\" class=\"control-label\">Province:<sup>*<\/sup> <\/label><br \/>\n<input type=\"text\" class=\"form-control\" id=\"input_province\" data-ng-model=\"mymodel.province\" placeholder=\"province\" name=\"province\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; mymodel.city == '' &amp;&amp; mymodel.province =='' }\" kl_vkbd_parsed=\"true\"><\/div>\n<div class=\"col-md-3\" data-ng-show=\"mymodel.usa == 'usa'\"><label for=\"input_state\" class=\"control-label\">State:<sup>*<\/sup> <\/label><\/p>\n<div class=\"select-container\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; myform.state.$error.required }\"><select id=\"input_state\" class=\"form-control\" name=\"state\" data-ng-model=\"mymodel.state\" required style=\"font-size:12px\">\r\n        <option value=\"\" selected=\"\">-- Select State --<\/option> \r\n        <option value=\"AL\">Alabama<\/option> \r\n        <option value=\"AK\">Alaska<\/option> \r\n        <option value=\"AZ\">Arizona<\/option> \r\n        <option value=\"AR\">Arkansas<\/option> \r\n        <option value=\"CA\">California<\/option> \r\n        <option value=\"CO\">Colorado<\/option>\r\n        <option value=\"CT\">Connecticut<\/option> \r\n        <option value=\"DE\">Delaware<\/option> \r\n        <option value=\"DC\">District of Columbia<\/option> \r\n        <option value=\"FL\">Florida<\/option>\r\n        <option value=\"GA\">Georgia<\/option> \r\n        <option value=\"HI\">Hawaii<\/option> \r\n        <option value=\"ID\">Idaho<\/option> \r\n        <option value=\"IL\">Illinois<\/option> \r\n        <option value=\"IN\">Indiana<\/option> \r\n        <option value=\"IA\">Iowa<\/option> \r\n        <option value=\"KS\">Kansas<\/option> \r\n        <option value=\"KY\">Kentucky<\/option>\r\n        <option value=\"LA\">Louisiana<\/option> \r\n        <option value=\"ME\">Maine<\/option> \r\n        <option value=\"MD\">Maryland<\/option> \r\n        <option value=\"MA\">Massachusetts<\/option> \r\n        <option value=\"MI\">Michigan<\/option>\r\n        <option value=\"MN\">Minnesota<\/option> \r\n        <option value=\"MS\">Mississippi<\/option> \r\n        <option value=\"MO\">Missouri<\/option>\r\n        <option value=\"MT\">Montana<\/option> \r\n        <option value=\"NE\">Nebraska<\/option> \r\n        <option value=\"NV\">Nevada<\/option>\r\n        <option value=\"NH\">New Hampshire<\/option> \r\n        <option value=\"NJ\">New Jersey<\/option> \r\n        <option value=\"NM\">New Mexico<\/option> \r\n        <option value=\"NY\">New York<\/option> \r\n        <option value=\"NC\">North Carolina<\/option> \r\n        <option value=\"ND\">North Dakota<\/option> \r\n        <option value=\"OH\">Ohio<\/option> \r\n        <option value=\"OK\">Oklahoma<\/option> \r\n        <option value=\"OR\">Oregon<\/option> \r\n        <option value=\"PA\">Pennsylvania<\/option>\r\n        <option value=\"RI\">Rhode Island<\/option> \r\n        <option value=\"SC\">South Carolina<\/option>\r\n        <option value=\"SD\">South Dakota<\/option> \r\n        <option value=\"TN\">Tennessee<\/option> \r\n        <option value=\"TX\">Texas<\/option>\r\n        <option value=\"UT\">Utah<\/option> \r\n        <option value=\"VT\">Vermont<\/option>\r\n        <option value=\"VA\">Virginia<\/option> \r\n        <option value=\"WA\">Washington<\/option> \r\n        <option value=\"WV\">West Virginia<\/option> \r\n        <option value=\"WI\">Wisconsin<\/option> \r\n        <option value=\"WY\">Wyoming<\/option>\r\n        <option value=\"INT\">*** Outside of United States<\/option>\r\n      <\/select><\/div>\n<\/div>\n<div class=\"col-sm-2 col-md-2\"><label for=\"input_postal\" class=\"control-label\">Postal:<sup>*<\/sup> <\/label><br \/>\n<input type=\"text\" class=\"form-control\" id=\"input_postal\" data-ng-model=\"mymodel.postal\" placeholder=\"postal\" name=\"postal\" required=\"\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; myform.postal.$error.required }\" kl_vkbd_parsed=\"true\"><\/div>\n<\/div>\n<div class=\"form-group\" data-ng-hide=\"mymodel.usa == 'usa'\"><label for=\"input_country\" class=\"form-control col-sm-3 control-label\">Country:<\/label><\/p>\n<div class=\"col-sm-5 col-md-5\">        <select id=\"input_country_id\" name=\"country_id\" data-ng-model=\"mymodel.country_id\" class=\"form-control\" style=\"font-size:12px\">\r\n        <option value=\"\">--- Select ---<\/option>\r\n        <option value=\"1\">Afghanistan<\/option>\r\n        <option value=\"2\">Albania<\/option>\r\n        <option value=\"3\">Algeria<\/option>\r\n        <option value=\"4\">American Samoa<\/option>\r\n        <option value=\"5\">Andorra<\/option>\r\n        <option value=\"6\">Angola<\/option>\r\n        <option value=\"7\">Anguilla<\/option>\r\n        <option value=\"8\">Antarctica<\/option>\r\n        <option value=\"9\">Antigua and Barbuda<\/option>\r\n        <option value=\"10\">Argentina<\/option>\r\n        <option value=\"11\">Armenia<\/option>\r\n        <option value=\"12\">Aruba<\/option>\r\n        <option value=\"13\">Australia<\/option>\r\n        <option value=\"14\">Austria<\/option>\r\n        <option value=\"15\">Azerbaijan<\/option>\r\n        <option value=\"16\">Bahamas<\/option>\r\n        <option value=\"17\">Bahrain<\/option>\r\n        <option value=\"18\">Bangladesh<\/option>\r\n        <option value=\"19\">Barbados<\/option>\r\n        <option value=\"20\">Belarus<\/option>\r\n        <option value=\"21\">Belgium<\/option>\r\n        <option value=\"22\">Belize<\/option>\r\n        <option value=\"23\">Benin<\/option>\r\n        <option value=\"24\">Bermuda<\/option>\r\n        <option value=\"25\">Bhutan<\/option>\r\n        <option value=\"26\">Bolivia<\/option>\r\n        <option value=\"27\">Bosnia and Herzegowina<\/option>\r\n        <option value=\"28\">Botswana<\/option>\r\n        <option value=\"29\">Bouvet Island<\/option>\r\n        <option value=\"30\">Brazil<\/option>\r\n        <option value=\"31\">British Indian Ocean Territory<\/option>\r\n        <option value=\"32\">Brunei Darussalam<\/option>\r\n        <option value=\"33\">Bulgaria<\/option>\r\n        <option value=\"34\">Burkina Faso<\/option>\r\n        <option value=\"35\">Burundi<\/option>\r\n        <option value=\"36\">Cambodia<\/option>\r\n        <option value=\"37\">Cameroon<\/option>\r\n        <option value=\"38\">Canada<\/option>\r\n        <option value=\"39\">Cape Verde<\/option>\r\n        <option value=\"40\">Cayman Islands<\/option>\r\n        <option value=\"41\">Central African Republic<\/option>\r\n        <option value=\"42\">Chad<\/option>\r\n        <option value=\"43\">Chile<\/option>\r\n        <option value=\"44\">China<\/option>\r\n        <option value=\"45\">Christmas Island<\/option>\r\n        <option value=\"46\">Cocos (Keeling) Islands<\/option>\r\n        <option value=\"47\">Colombia<\/option>\r\n        <option value=\"48\">Comoros<\/option>\r\n        <option value=\"49\">Congo<\/option>\r\n        <option value=\"50\">Cook Islands<\/option>\r\n        <option value=\"51\">Costa Rica<\/option>\r\n        <option value=\"52\">Cote D'Ivoire<\/option>\r\n        <option value=\"53\">Croatia<\/option>\r\n        <option value=\"54\">Cuba<\/option>\r\n        <option value=\"55\">Cyprus<\/option>\r\n        <option value=\"56\">Czech Republic<\/option>\r\n        <option value=\"57\">Denmark<\/option>\r\n        <option value=\"58\">Djibouti<\/option>\r\n        <option value=\"59\">Dominica<\/option>\r\n        <option value=\"60\">Dominican Republic<\/option>\r\n        <option value=\"61\">East Timor<\/option>\r\n        <option value=\"62\">Ecuador<\/option>\r\n        <option value=\"63\">Egypt<\/option>\r\n        <option value=\"64\">El Salvador<\/option>\r\n        <option value=\"65\">Equatorial Guinea<\/option>\r\n        <option value=\"66\">Eritrea<\/option>\r\n        <option value=\"67\">Estonia<\/option>\r\n        <option value=\"68\">Ethiopia<\/option>\r\n        <option value=\"69\">Falkland Islands (Malvinas)<\/option>\r\n        <option value=\"70\">Faroe Islands<\/option>\r\n        <option value=\"71\">Fiji<\/option>\r\n        <option value=\"72\">Finland<\/option>\r\n        <option value=\"73\">France<\/option>\r\n        <option value=\"74\">France, Metropolitan<\/option>\r\n        <option value=\"75\">French Guiana<\/option>\r\n        <option value=\"76\">French Polynesia<\/option>\r\n        <option value=\"77\">French Southern Territories<\/option>\r\n        <option value=\"78\">Gabon<\/option>\r\n        <option value=\"79\">Gambia<\/option>\r\n        <option value=\"80\">Georgia<\/option>\r\n        <option value=\"81\">Germany<\/option>\r\n        <option value=\"82\">Ghana<\/option>\r\n        <option value=\"83\">Gibraltar<\/option>\r\n        <option value=\"84\">Greece<\/option>\r\n        <option value=\"85\">Greenland<\/option>\r\n        <option value=\"86\">Grenada<\/option>\r\n        <option value=\"87\">Guadeloupe<\/option>\r\n        <option value=\"88\">Guam<\/option>\r\n        <option value=\"89\">Guatemala<\/option>\r\n        <option value=\"90\">Guinea<\/option>\r\n        <option value=\"91\">Guinea-bissau<\/option>\r\n        <option value=\"92\">Guyana<\/option>\r\n        <option value=\"93\">Haiti<\/option>\r\n        <option value=\"94\">Heard and Mc Donald Islands<\/option>\r\n        <option value=\"95\">Honduras<\/option>\r\n        <option value=\"96\">Hong Kong<\/option>\r\n        <option value=\"97\">Hungary<\/option>\r\n        <option value=\"98\">Iceland<\/option>\r\n        <option value=\"99\">India<\/option>\r\n        <option value=\"100\">Indonesia<\/option>\r\n        <option value=\"101\">Iran (Islamic Republic of)<\/option>\r\n        <option value=\"102\">Iraq<\/option>\r\n        <option value=\"103\">Ireland<\/option>\r\n        <option value=\"104\">Israel<\/option>\r\n        <option value=\"105\">Italy<\/option>\r\n        <option value=\"106\">Jamaica<\/option>\r\n        <option value=\"107\">Japan<\/option>\r\n        <option value=\"108\">Jordan<\/option>\r\n        <option value=\"109\">Kazakhstan<\/option>\r\n        <option value=\"110\">Kenya<\/option>\r\n        <option value=\"111\">Kiribati<\/option>\r\n        <option value=\"112\">Korea, Democratic People's Republic of<\/option>\r\n        <option value=\"113\">Korea, Republic of<\/option>\r\n        <option value=\"114\">Kuwait<\/option>\r\n        <option value=\"115\">Kyrgyzstan<\/option>\r\n        <option value=\"116\">Lao People's Democratic Republic<\/option>\r\n        <option value=\"117\">Latvia<\/option>\r\n        <option value=\"118\">Lebanon<\/option>\r\n        <option value=\"119\">Lesotho<\/option>\r\n        <option value=\"120\">Liberia<\/option>\r\n        <option value=\"121\">Libyan Arab Jamahiriya<\/option>\r\n        <option value=\"122\">Liechtenstein<\/option>\r\n        <option value=\"123\">Lithuania<\/option>\r\n        <option value=\"124\">Luxembourg<\/option>\r\n        <option value=\"125\">Macau<\/option>\r\n        <option value=\"126\">Macedonia, The Former Yugoslav Republic of<\/option>\r\n        <option value=\"127\">Madagascar<\/option>\r\n        <option value=\"128\">Malawi<\/option>\r\n        <option value=\"129\">Malaysia<\/option>\r\n        <option value=\"130\">Maldives<\/option>\r\n        <option value=\"131\">Mali<\/option>\r\n        <option value=\"132\">Malta<\/option>\r\n        <option value=\"133\">Marshall Islands<\/option>\r\n        <option value=\"134\">Martinique<\/option>\r\n        <option value=\"135\">Mauritania<\/option>\r\n        <option value=\"136\">Mauritius<\/option>\r\n        <option value=\"137\">Mayotte<\/option>\r\n        <option value=\"138\">Mexico<\/option>\r\n        <option value=\"139\">Micronesia, Federated States of<\/option>\r\n        <option value=\"140\">Moldova, Republic of<\/option>\r\n        <option value=\"141\">Monaco<\/option>\r\n        <option value=\"142\">Mongolia<\/option>\r\n        <option value=\"143\">Montserrat<\/option>\r\n        <option value=\"144\">Morocco<\/option>\r\n        <option value=\"145\">Mozambique<\/option>\r\n        <option value=\"146\">Myanmar<\/option>\r\n        <option value=\"147\">Namibia<\/option>\r\n        <option value=\"148\">Nauru<\/option>\r\n        <option value=\"149\">Nepal<\/option>\r\n        <option value=\"150\">Netherlands<\/option>\r\n        <option value=\"151\">Netherlands Antilles<\/option>\r\n        <option value=\"152\">New Caledonia<\/option>\r\n        <option value=\"153\">New Zealand<\/option>\r\n        <option value=\"154\">Nicaragua<\/option>\r\n        <option value=\"155\">Niger<\/option>\r\n        <option value=\"156\">Nigeria<\/option>\r\n        <option value=\"157\">Niue<\/option>\r\n        <option value=\"158\">Norfolk Island<\/option>\r\n        <option value=\"159\">Northern Mariana Islands<\/option>\r\n        <option value=\"160\">Norway<\/option>\r\n        <option value=\"161\">Oman<\/option>\r\n        <option value=\"162\">Pakistan<\/option>\r\n        <option value=\"163\">Palau<\/option>\r\n        <option value=\"164\">Panama<\/option>\r\n        <option value=\"165\">Papua New Guinea<\/option>\r\n        <option value=\"166\">Paraguay<\/option>\r\n        <option value=\"167\">Peru<\/option>\r\n        <option value=\"168\">Philippines<\/option>\r\n        <option value=\"169\">Pitcairn<\/option>\r\n        <option value=\"170\">Poland<\/option>\r\n        <option value=\"171\">Portugal<\/option>\r\n        <option value=\"172\">Puerto Rico<\/option>\r\n        <option value=\"173\">Qatar<\/option>\r\n        <option value=\"174\">Reunion<\/option>\r\n        <option value=\"175\">Romania<\/option>\r\n        <option value=\"176\">Russian Federation<\/option>\r\n        <option value=\"177\">Rwanda<\/option>\r\n        <option value=\"178\">Saint Kitts and Nevis<\/option>\r\n        <option value=\"179\">Saint Lucia<\/option>\r\n        <option value=\"180\">Saint Vincent and the Grenadines<\/option>\r\n        <option value=\"181\">Samoa<\/option>\r\n        <option value=\"182\">San Marino<\/option>\r\n        <option value=\"183\">Sao Tome and Principe<\/option>\r\n        <option value=\"184\">Saudi Arabia<\/option>\r\n        <option value=\"185\">Senegal<\/option>\r\n        <option value=\"186\">Seychelles<\/option>\r\n        <option value=\"187\">Sierra Leone<\/option>\r\n        <option value=\"188\">Singapore<\/option>\r\n        <option value=\"189\">Slovakia (Slovak Republic)<\/option>\r\n        <option value=\"190\">Slovenia<\/option>\r\n        <option value=\"191\">Solomon Islands<\/option>\r\n        <option value=\"192\">Somalia<\/option>\r\n        <option value=\"193\">South Africa<\/option>\r\n        <option value=\"194\">South Georgia and the South Sandwich Islands<\/option>\r\n        <option value=\"195\">Spain<\/option>\r\n        <option value=\"196\">Sri Lanka<\/option>\r\n        <option value=\"197\">St. Helena<\/option>\r\n        <option value=\"198\">St. Pierre and Miquelon<\/option>\r\n        <option value=\"199\">Sudan<\/option>\r\n        <option value=\"200\">Suriname<\/option>\r\n        <option value=\"201\">Svalbard and Jan Mayen Islands<\/option>\r\n        <option value=\"202\">Swaziland<\/option>\r\n        <option value=\"203\">Sweden<\/option>\r\n        <option value=\"204\">Switzerland<\/option>\r\n        <option value=\"205\">Syrian Arab Republic<\/option>\r\n        <option value=\"206\">Taiwan<\/option>\r\n        <option value=\"207\">Tajikistan<\/option>\r\n        <option value=\"208\">Tanzania, United Republic of<\/option>\r\n        <option value=\"209\">Thailand<\/option>\r\n        <option value=\"210\">Togo<\/option>\r\n        <option value=\"211\">Tokelau<\/option>\r\n        <option value=\"212\">Tonga<\/option>\r\n        <option value=\"213\">Trinidad and Tobago<\/option>\r\n        <option value=\"214\">Tunisia<\/option>\r\n        <option value=\"215\">Turkey<\/option>\r\n        <option value=\"216\">Turkmenistan<\/option>\r\n        <option value=\"217\">Turks and Caicos Islands<\/option>\r\n        <option value=\"218\">Tuvalu<\/option>\r\n        <option value=\"219\">Uganda<\/option>\r\n        <option value=\"220\">Ukraine<\/option>\r\n        <option value=\"221\">United Arab Emirates<\/option>\r\n        <option value=\"222\">United Kingdom<\/option>\r\n        <option value=\"223\">United States<\/option>\r\n        <option value=\"224\">United States Minor Outlying Islands<\/option>\r\n        <option value=\"225\">Uruguay<\/option>\r\n        <option value=\"226\">Uzbekistan<\/option>\r\n        <option value=\"227\">Vanuatu<\/option>\r\n        <option value=\"228\">Vatican City State (Holy See)<\/option>\r\n        <option value=\"229\">Venezuela<\/option>\r\n        <option value=\"230\">Viet Nam<\/option>\r\n        <option value=\"231\">Virgin Islands (British)<\/option>\r\n        <option value=\"232\">Virgin Islands (U.S.)<\/option>\r\n        <option value=\"233\">Wallis and Futuna Islands<\/option>\r\n        <option value=\"234\">Western Sahara<\/option>\r\n        <option value=\"235\">Yemen<\/option>\r\n        <option value=\"236\">Yugoslavia<\/option>\r\n        <option value=\"237\">Zaire<\/option>\r\n        <option value=\"238\">Zambia<\/option>\r\n        <option value=\"239\">Zimbabwe<\/option>\r\n      <\/select><\/div>\n<\/div>\n<div class=\"form-group\"><label class=\"col-sm-12 col-md-12 control-label\">Type of business (please check all that apply):<\/label><\/p>\n<div class=\"col-sm-6 col-md-6 clearfix\" data-ng-init=\"mymodel.biztype = []\">\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[0]\" data-ng-true-value=\"'SCREENPRINTING'\" kl_vkbd_parsed=\"true\"> Screen Printing\/Embroidery Service<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[1]\" data-ng-true-value=\"'GOVERNMENTAL'\" kl_vkbd_parsed=\"true\"> State\/Fed. Govt. Agency<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[2]\" data-ng-true-value=\"'ADSPECIALTY'\" kl_vkbd_parsed=\"true\"> Ad Specialties\/Distributor<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[3]\" data-ng-true-value=\"'NONPROFIT'\" kl_vkbd_parsed=\"true\"> Non-Profit\/Charitable Organization<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[4]\" data-ng-true-value=\"'ONLINERETAIL'\" kl_vkbd_parsed=\"true\"> Online Retail\/Mail-Order<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[5]\" data-ng-true-value=\"'COLLEGE'\" kl_vkbd_parsed=\"true\"> College, University, Academic\/Professional Organization<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[6]\" data-ng-true-value=\"'CORPORATE'\" kl_vkbd_parsed=\"true\"> Corporate chain<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[7]\" data-ng-true-value=\"'INDBIZ'\" kl_vkbd_parsed=\"true\"> Independent Business\/Yoga Studio\/Spa\/Resort\/Physical Storefront<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[8]\" data-ng-true-value=\"'SUSTAINABLE'\" kl_vkbd_parsed=\"true\"> For-profit Sustainable Business<\/label><\/div>\n<div class=\"checkbox\"><label><input type=\"checkbox\" data-ng-model=\"mymodel.biztype[9]\" data-ng-true-value=\"'OTHER'\" kl_vkbd_parsed=\"true\"> Other (please describe)<\/label><\/div>\n<p>Specify: <input type=\"text\" class=\"form-control\" data-ng-model=\"mymodel.otherdesc\" value=\"\" kl_vkbd_parsed=\"true\"><\/p>\n<\/div>\n<\/div>\n<div class=\"form-group\">\n<div class=\"resale-inst col-md-12 label label-info\" data-ng-if=\"reveal\">Resale Certificate\/Sales Permit # issued by your state sales tax collection agency. Businesses located in AK, DE, MT, OR, NH write N\/A. Businesses using products for giveaways, staff use or promotional purposes may write N\/A if not available.<\/div>\n<p><label class=\"col-sm-12 col-md-12 control-label\">Qualifying Business Information (for quick approval please provide all\/any information to help us establish you as a reseller) <\/label><\/p>\n<div class=\"col-sm-4 col-md-4 clearfix\">Resale ID (Sellers Permit): <a data-ng-click=\"reveal = !reveal\">what is this?<\/a> <input maxlength=\"30\" type=\"text\" data-ng-model=\"mymodel.resaleid\" class=\"form-control\" name=\"resaleid\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; myform.resaleid.$error.required }\" kl_vkbd_parsed=\"true\"><\/p>\n<p>Federal Tax ID#(EIN# or SSN#): <input maxlength=\"20\" type=\"text\" data-ng-model=\"mymodel.ein\" class=\"form-control\" kl_vkbd_parsed=\"true\"><br \/>\nASI\/PPAI Distributor #: <input type=\"text\" maxlength=\"20\" data-ng-model=\"mymodel.distributor\" class=\"form-control\" kl_vkbd_parsed=\"true\"><br \/>\nBusiness Website: <input type=\"text\" maxlength=\"100\" data-ng-model=\"mymodel.website\" class=\"form-control\" kl_vkbd_parsed=\"true\"><\/p>\n<\/div>\n<\/div>\n<div class=\"form-group\"><label class=\"col-sm-12 col-md-12 control-label\">How will the products be altered (please check all that apply): <sup>*<\/sup> <\/label><\/p>\n<div class=\"col-sm-12 col-md-12 clearfix\" data-ng-init=\"mymodel.usetype = []\" data-ng-class=\"{ 'has-error' :  submitted &amp;&amp; mymodel.usetype.length == 0 }\"><label class=\"checkbox-inline\"><input type=\"checkbox\" data-ng-model=\"mymodel.usetype[0]\" data-ng-true-value=\"'SCREENPRINTING'\" kl_vkbd_parsed=\"true\"> Screen Printed<\/label><br \/>\n<label class=\"checkbox-inline\"><input type=\"checkbox\" data-ng-model=\"mymodel.usetype[1]\" data-ng-true-value=\"'EMBROIDERED'\" kl_vkbd_parsed=\"true\"> Embroidered<\/label><br \/>\n<label class=\"checkbox-inline\"><input type=\"checkbox\" data-ng-model=\"mymodel.usetype[2]\" data-ng-true-value=\"'RELABELED'\" kl_vkbd_parsed=\"true\"> Relabeled<\/label><br \/>\n<label class=\"checkbox-inline\"><input type=\"checkbox\" data-ng-model=\"mymodel.usetype[3]\" data-ng-true-value=\"'RESOLD'\" kl_vkbd_parsed=\"true\"> Resold<\/label><br \/>\n<label class=\"checkbox-inline\"><input type=\"checkbox\" data-ng-model=\"mymodel.usetype[4]\" data-ng-true-value=\"'REFASHIONED'\" kl_vkbd_parsed=\"true\"> Refashioned<\/label><\/div>\n<\/div>\n<div class=\"form-group\"><label class=\"col-sm-12 col-md-12 control-label\">How did you find us? <\/label><\/p>\n<div class=\"col-sm-6 col-md-6 clearfix\"><label class=\"radio-inline\"><input type=\"radio\" name=\"findus\" data-ng-model=\"mymodel.findus\" value=\"INTERNET\" kl_vkbd_parsed=\"true\"> Internet Search<\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"findus\" data-ng-model=\"mymodel.findus\" value=\"WEBSITELINK\" kl_vkbd_parsed=\"true\"> Website link <\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"findus\" data-ng-model=\"mymodel.findus\" value=\"OTHER\" kl_vkbd_parsed=\"true\"> Other<\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"findus\" data-ng-model=\"mymodel.findus\" value=\"SALESREP\" kl_vkbd_parsed=\"true\"> Contacted by our salesperson\/staff <\/label><br \/>\n<input type=\"radio\" name=\"findus\" data-ng-model=\"mymodel.findus\" checked=\"checked\" value=\"NOTPROVIDED\" style=\"display: none;\" kl_vkbd_parsed=\"true\"><\/p>\n<p data-ng-show=\"mymodel.findus == 'SALESREP'\">Please provide their name so we can give them credit! <input type=\"text\" class=\"form-control\" name=\"mymodel.ourrep\" kl_vkbd_parsed=\"true\"><\/p>\n<\/div>\n<\/div>\n<div class=\"form-group\"><label class=\"col-sm-12 col-md-12 control-label\">Additional Notes and Details:<\/label><\/p>\n<div class=\"col-sm-12 col-md-12 clearfix\"><label class=\"input-inline\">Expected Quantity and Frequency of your Requirement: <input maxlength=\"50\" type=\"text\" data-ng-model=\"mymodel.expectedqty\" kl_vkbd_parsed=\"true\"> pieces <\/label><\/div>\n<div class=\"col-sm-10 col-md-10 clearfix\"><label class=\"radio-inline\"><input type=\"radio\" name=\"freq\" data-ng-model=\"mymodel.frequency\" value=\"MONTHLY\" kl_vkbd_parsed=\"true\"> Monthly<\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"freq\" data-ng-model=\"mymodel.frequency\" value=\"FEWMONTHS\" kl_vkbd_parsed=\"true\"> Every few months<\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"freq\" data-ng-model=\"mymodel.frequency\" value=\"ANNUALLY\" kl_vkbd_parsed=\"true\"> Annually<\/label><br \/>\n<label class=\"radio-inline\"><input type=\"radio\" name=\"freq\" data-ng-model=\"mymodel.frequency\" value=\"ONCE\" kl_vkbd_parsed=\"true\"> One time Only<\/label><br \/>\n<input type=\"radio\" name=\"freq\" data-ng-model=\"mymodel.frequency\" checked=\"checked\" value=\"NOTPROVIDED\" style=\"display: none;\" kl_vkbd_parsed=\"true\"><br \/>\n<textarea class=\"form-control\" id=\"input_details\" name=\"details\" data-ng-model=\"mymodel.details\" placeholder=\"additional details\"><\/textarea><\/div>\n<\/div>\n<div class=\"form-group\">\n<div class=\"col-sm-4 col-md-4\"><button type=\"button\" class=\"btn btn-success\" data-ng-click=\"send()\" data-ng-disabled=\"processing\"><i class=\"fa fa-circle-o-notch fa-spin\" data-ng-show=\"processing\"><\/i>Submit<\/button><\/div>\n<\/div>\n<div class=\"form-group\">\n<div class=\"col-sm-5 col-md-4\"><small><sup>*<\/sup> required fields<\/small><\/div>\n<\/div>\n<\/form>\n","protected":false},"excerpt":{"rendered":"<p>Thank you for your interest in HAE Now&#8217;s fair trade organic cotton products. To establish a wholesale account for your business please submit the form below. If sufficient qualifying information is provided, access to our wholesale pricing and online ordering is usually granted within a few business hours. Note: If you have an approved wholesale [&hellip;]<\/p>\n","protected":false},"author":18,"featured_media":0,"parent":359,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"templates\/no-sidebar.php","meta":{"nf_dc_page":"","footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-368","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/pages\/368","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/comments?post=368"}],"version-history":[{"count":54,"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/pages\/368\/revisions"}],"predecessor-version":[{"id":2468,"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/pages\/368\/revisions\/2468"}],"up":[{"embeddable":true,"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/pages\/359"}],"wp:attachment":[{"href":"https:\/\/www.haenow.com\/content\/wp-json\/wp\/v2\/media?parent=368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}