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Retailer Signup

Thank you for your interest in becoming a CW Botanicals retailer. Please complete the form below to begin the application process. After reviewing your company information we will do our best to respond as soon as possible.

Please note: You must have a physical store location to be considered. We are not accepting e-commerce applications at this time.
Reseller Application East/West
First Name*
Last Name*
Title*
Company*
Federal EIN (If UK/EU, use VAT Number)*
Industry*
Website
Phone*
Email*
Street*
City*
State*
Zip Code*
Country*
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