How to Apply for a Millage Dealership:

Please provide your company information with the form below. We will process your application as soon as possible, and will issue your user id and password by sending it to the email address provided. Approval as a dealer usually takes about 7 - 10 business days. If you would prefer to print this application and send it by mail or fax, Click Here

If you are already a Millage dealer and would like an online account, you may either use this form to apply or contact your Millage sales rep directly.


United States Dealer Application
If you are not in the United States, click here

Millage account number:
 Please leave blank if you do not already have an account.
Corporation or Owner name:
DBA name:
Federal Tax ID:
Contact person:
Contact person's position:
Business start date:
    (yyyy-mm-dd)

Business Address

Street:
 
City:
State:
Zip code:
Country:
USA
At this location since:
    (yyyy-mm-dd)

Communication data

Telephone:
FAX:
Email:
Website:

Business profile     (Check all that apply)

Business Location Type:
Destination Store
Web Site
Kiosk
Mall Location
Shopping District
Swap / Outdoor Market

Type of retail:
Fashion Boutique
Accessories
Sporting Goods
Jewelry Store
General Gifts
Discount Value Store
Watch Store

Target customer:
Male
Female
Unisex

Customer age range:
0 - 17
18 - 23
24 - 30
31 - 40
41 - 55
55+


NOTE: This is the Millage Retail Dealer Application. If you sell primarily to other retailers and have a solid supplier relationship with quality jewelry stores, men's stores, high end boutiques, quality chain stores, department stores, etc. then apply to become a Millage Distributor.

Click here for the Wholesale Distributor Application.

2000 - 2018 - Millage Inc.

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