Marketplace Application

please provide the required information to save the application.

First Name

Last Name

Job Title

Email Address Should match with confirm email.

Confirm Email Address Should match with confirm email.

Your Primary Time Zone Optional

Phone

Ext. Optional

Mobile Optional

Permission to Text

Legal Company Name

Company Website Optional

Annual Online Sales Revenue (USD)

Primary Category Based On Sales

How Did You Hear About Walmart Marketplace?

Solution Provider name

Please Specify How You Heard About Walmart ?

Legal Company Name

DBA Name Optional

Is your company headquartered in United States?

Yes No

US Tax ID (EIN)US Tax ID (EIN) / Canada BNCanada BN

State of IncorporationProvince of Incorporation

Year Company was Founded

Address Line 1

Address Line 2 Optional

City

Country

StateProvince

Zip CodePostal Code

A diverse supplier is defined as a U.S. privately held company that is 51% owned and operated by a woman, minority, veteran, disable veteran, person with a disability or a member of the lesbian, gay, bisexual or transgender (LGBT) community.

Are you a diverse supplier? ?

Yes No

African American

Asian Americans

Disabled Veteran

Hispanic American

LGBT

Native Alaskan

Native American

People with Disabilities

Veteran

Women

Seller Type (Please check all that apply)

Brand

Manufacturer

Retailer

Distributor

Liquidator

Drop-shipper

Importer

Etailer (pure play)

Annual Sales Revenue (Offline and Online) (USD)

Annual U.S.Sales Revenue (Offline and Online)

Annual Sales Revenue (Online Only) (USD)

Primary Category Based On Sales

Annual Online Revenue (USD)

Total SKUs in Catalog

Projected SKUs on Walmart.com

Secondary Category Optional

Annual Online Revenue (USD)

Total SKUs in Catalog

Projected SKUs on Walmart.com

Tertiary Category Optional

Annual Online Revenue (USD)

Total SKUs in Catalog

Projected SKUs on Walmart.com

All Other Categories Optional

Annual Online Revenue (USD)

Total SKUs in Catalog

Projected SKUs on Walmart.com

TOTAL The total value must be equal to or less than the amount entered in the Annual U.S. Sales Revenue (Offline and Online) field on the Business Information tab.

TOTAL

Do You Sell Any Of The Following? Select all that apply

Fragrance

Luxury Brands

Cell Phone & Accessories

Software

% Of SKUs With UPC Codes

% Of Sales From Used Items

% Of Sales From Refurbished Items

Top Keyword Searches For Your products Optional

Top Selling Brands Optional

Top Selling Products Optional

Your Webstore information

N/A

Number Of Active SKUs

Annual Online Revenue On Your Webstore (USD)

Average Order Value (USD)

Webstore Experience (in years)

Independent Seller Reviews

Google Trusted Sites

Shopper Approved

Reseller Ratings

Trust Pilot

Other

Select Webstores
Check all that apply

Amazon

eBay

Other

None

Please select atleast 1 option.

Amazon Webstore Information

Amazon Webstore URL

Amazon Seller Name

Number Of Active SKUs On Amazon

Annual Online Revenue On Amazon (USD)

Average Order Value On Amazon (USD)

Total Reviews on Amazon (Past 12 Months)

Positive Rating % On Amazon

Amazon Marketplace Experience (in years)

eBay Webstore Information

eBay Webstore URL

eBay Seller Name

Number Of Active SKUs On eBay

Annual Online Revenue On eBay (USD)

Average Order Value On eBay (USD)

Total Reviews on eBay (Past 12 Months)

Positive Rating % On eBay

eBay Marketplace Experience (in years)

Other Marketplace Information

Other Marketplace URL

Seller Name

Number Of Active SKUs

Annual Online Revenue (USD)

Average Order Value (USD)

Total Reviews (Past 12 Months)

Positive Rating %

Other Marketplace Experience (in years)

List Any Other Marketplace Storefront URLs Optional

% Of SKUs Owned

% Of SKUs Dropshipped

% of SKUs you currently fulfill with FBA

Primary U.S. Warehouse Street Address

Suite Optional

City

State

Zip Code

How Many Business Days to Pick and Ship Orders?

Current Shipping Methods
Check all that apply

UPS

FEDEX

USPS

DHL

FBA

Other

Do you have customer service representatives
available from 9am-6pm (EST-PST)?

Yes No

Customer Return Policy:

Current selling relationships you have with Walmart
Check all that apply

Walmart Stores

Walmart.com Supplier

Walmart.com DSV

Jet.com

None

Sign Agreement

Please read and accept the terms of the retailer agreement.

By checking “I AGREE” located below or by offering any Products for sale on the Walmart.com Marketplace, using any of the Walmart.com Services, or using any of the Walmart.com Tools, you agree to be bound by all terms and conditions of this Agreement (including the Retailer Policies), as this Agreement (or the Retailer Policies) may be updated from time to time in accordance with this Agreement. You further represent and warrant that you are registering with the Walmart.com Marketplace on behalf of an entity and that you have the requisite right, power, and authority to enter into this Agreement on behalf of the entity you register with the Walmart.com Marketplace.

By:

Name:

Title:

Phone:

Email:

I Agree.
Please select I Agree checkbox.

Agreement will be effective as of the date Retailer clicks “I Agree” below.

Business License or Tax Registration

Please select file.

ID of all listed shareholders

Please select file.

Tax Document (W9, W8-BEN-E, W8-BECI)

Please select file.

Company Organization Structure & Team profile Optional

Please select file.

Names of all shareholders who has more than 10% stake in the company Optional

Please select file.