Retailer registration (Brennan's version) First Name Last Name Username Email Phone Number Password Are you signing up as a company? Please only choose 1 response. Yes No Company Type Please Select E-Commerce Selling as an Individual Brick and Mortar E-Commerce and Brick and Mortar Do you have experience selling on Amazon or other e-commerce sites? Please select I've never sold before Some experience I'm an experienced e-commerce seller Would you be interested in finding out how to sign up as a company? Yes No Company Name What is your monthly revenue? Please select $0.00/I have not started Under $500 $500 - $1k $1k - $5k $5k - $10k $10k - $20k $20k - $50k $50k - $100k $100k+ Do you sell on Amazon? Yes No What's your Amazon Store name? Country Please Select Afghanistan Albania Algeria Andorra Angola Antigua & Deps Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Brunei Bulgaria Burkina Burundi Cambodia Cameroon Canada Cape Verde Central African Rep Chad Chile China Colombia Comoros Congo Congo {Democratic Rep} Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland {Republic} Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar, {Burma} Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda St Kitts & Nevis St Lucia Saint Vincent & the Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe Business or Home Street Address Apt./Unit # City State Website URL How do you handle shipments? Please select Direct to Fulfillment/Prep Center (Amazon, Etc.) Your own fulfillment center This doesn't apply to me Would you be interested in learning about our Brex card that helps small businesses? Yes No Do you have a Sellers permit for your state? Yes No Do you have an Amazon Sellers account? Yes No What's your Amazon Store name? Please put in N/A if this doesn't not apply to you. How much do you plant to start with? Please keep in mind our minimum is $3k, but you can still sign up! Less than $3k $3k $3k - $5k $5k - $10k $10k - $15k $15k - $20k $20k+ Submit Retailer registration First Name Last Name Username Email Password Company Name Type of Company Please select E-Commerce Selling as an individual Brick and Mortar (Physical) Both E-Commerce and Brick and Mortar Experience as a seller Never sold before Starting investment range 3k-5k 5k-10k 20k-50k Other How much do you plan to start with? (For now our minimum is $3000 but you can sign up still!) Phone number Website URL If you are an E-Commerce business Do you sell on Amazon? If so what is your store name: (We collect this information to make sure users don't violate MAP/Marketplace Restrictions) Please provide the address that you use for your Amazon Seller account. If you’re still not an Amazon Seller, please use this address when signing up because it’s needed for your invoice. Country: Afghanistan Albania Algeria Andorra Angola Antigua & Deps Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Brunei Bulgaria Burkina Burundi Cambodia Cameroon Canada Cape Verde Central African Rep Chad Chile China Colombia Comoros Congo Congo {Democratic Rep} Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland {Republic} Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar, {Burma} Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda St Kitts & Nevis St Lucia Saint Vincent & the Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe State: Please select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming How do you handle Shipments: Please select Direct to Fulfillment/Prep Center (Amazon, etc) Your own fulfillment center What is your monthly revenue: Please select $0.00 / I have not started Under $500.00 $501-$1k $1000.01-$5k $5k-$10k $10k-$20k $20K-$50k $50k-$100k $100k+ How did you hear about Invidica? Please select Word of Mouth Newsletters/ News Venture Capital/ Investors Brex Other Is you company incorporated? Yes No Would you be interested in incorporating your company? Yes No Do you have your sellers permit for your state? Yes No Do you have an Amazon sellers account? Yes No To register Amazon seller account you need: - Bank Statement - Bank account info - Government issued ID Submit
