Retailer Signup

If you are an e-commerce, vape shop or home business you will not be approved for partnership. Only natural retail and medical locations are being accepted.
 
Retailer Application: Please allow up to 14 business days for all retail applications to be processed.
First Name*
Last Name*
Title*
Company*
Federal EIN (If UK/EU, use VAT Number)*
Industry*
Do you intend to sell products online?*
Do you have a physical brick and mortar store that you intend to sell products in?*
Are you part of a medical or therapeutic practice?*
Are you a vape/smoke shop?*
Website
Phone*
Email*
Business Address*
City*
State*
Zip Code*
Country*
How did you hear about us?*
If other, please specify:
If referred by another company, please list it (Referral codes here)
Estimate Yearly Sales Interest*
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