Membership Application form for North America

IRS document or Articles of Incorporation, Articles of Organization

Upload your business license here.*

"Please confirm that your Company Name, Address, and Representative's Name are clearly written on the document.*

Please Enter Your Company’s Information

Company Name*

*Please enter the name of your company as it appears on your business license.

Legal First Name of Representative*

*Please enter the first name as listed on the business license.

Legal Middle Name of Representative

*Please enter the middle name as listed on the business license.

Legal Last Name of Representative*

*Please enter the last name of the representative listed on the business license.

Representative E-mail Address*

Representative Phone Number*

Please enter the website Link or social media link where the product is available.*

［Examples］
・Website Link: https://biz.komehyo-auction.com/en/
・Social Media Link : https://www.facebook.com/profile.php?id=61555663143886
・Physical store only

Country of Business*

States*

Other Country Name*

Business Address - Street Address (1st line)*

Street Address (2nd line)

City*

Zip Code*

Types of Products Your Company Resell*

Multiple answers allowed.

JewelryWatchBagApparel

Contact Information of the Person in Charge.

**Please fill this out if different from the above.**

First Name

Last Name

Email AddressPhone Number

I agree to privacy policy.*