Retailer application

We appreciate your interest on our products! We would kindly ask you to fill this form out. We will notify you, as soon as you are approved as a retailer. Thank you!

Your name*:
Name of your shop*:
Company name*: Tax Number*:
Address of shop*:
Website: Email*: Tel*:

* The fields are required.

Which products are you interested in:

  • Liliputi Soft Soled Shoes
  • Liliputi baby carriers and accessories

Type of retailer:

Describe your shop including: product ranges, shop location, brands you offer, year of foundation:

Questions, notes:

+

Security Image:

CAPTCHA Image

Result of the operation in security image*: