Wholesale Accounts

Apply for a wholesale account with Lani Simpson to get wholesale discounts on our products.

Please fill out the form below completely to apply for a Wholesale Account with us.

IMPORTANT! Please note that there is a $100 order minimum for all wholesale customers and free shipping is met with a purchase of $150

All applications will be reviewed and those who qualify will be emailed with account information and will be able to shop for products with us at wholesale prices. Please note too that orders may not be made outside of the United States at this time.

If you have any questions or comments about the form or about whether or not you qualify for an account, please contact us.

All form fields are required.

First Name:
 Last Name:
Email Address:
Professional License #:
Street Address
City:
State:
Zip:
Phone:

How/where will you be reselling our products?

What would you like your wholesale account password to be? Please enter it below. (If nothing is entered, we'll create it for you and notify you.)
Your Password:
Additional Details/Comments