Marietta Antique Mall
www.mariettaantiquemall.com 
1477 Roswell Road, Suite 100
Marietta, GA  30062

770-973-5600

Dealer Name: _________________________________ Date:___________

Business Name: _______________________________________________

Phone #s:  Check best number.
  Cell ______________ Home ______________ Other _________________

Email Address: ________________________________________________

TYPE OF MERCHANDISE YOU WILL SELL: ___________________________

____________________________________________________________ 

Are you new to the resale business?  Yes / No

If not new to resale, how long have you been in this industry? ________________________

Please indicate your current and past associations with other Antique Malls.

What size/type space do you need? _________________________________

What is your requested move-in month? ___________________________

Please upload photographs of samples of your merchandise here or email them to: ContactUs@mariettaantiquemall.com                   Use control-P to print this page.