Wholesale Application

First Name*

Last Name*

Email Address*

Phone Number

Street Address*

City*

State*

Zip Code*

Company Name*

Business Website*

Do you have an EIN
YesNo

Do you currently purchase CBD?
YesNo

Define your type of business?*
E-CommerceBrick & MorterE-Commerce / Brick & MorterOther

How did you hear about us?*
Social MediaLinkedInGoogleConferenceOther

Tell us about your business?*