Choice Wholesale Application Form
Thank you for your interest in Choice Botanicals. Kindly fill out the form below. You may also email us directly at sales@choicenutritionllc.com
Full Name
*
First Name
Last Name
Business Name:
*
Phone Number
*
Email
*
example@example.com
Shipping Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Business
E-Commerce Platform
Smoke Shop
Convenience Store
Distributor
Website:
Preferred Method Of Contact
Phone
Text
Email
Message? Comments?
NOTE:
We do ask that all new stores provide a copy of their IRS issued EIN number and/or your Tax ID Certificate to help us verify your business. We cannot process orders without these documents. To add this information and speed up your order process click NEXT. You can also send your documents directly via email, sales@choicenutritionllc.com.
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Business Requirements
We do ask that all new stores provide a copy of their IRS issued EIN number and/or your Tax ID Certificate to help us verify your business. You can also send your documentation directly to our email address sales@choicenutritionllc.com.
EIN Number
EIN Document
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Tax ID Certificate
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Choice Products
Kindly let us know which choice products you are interested in purchasing.
Kratom Capsules
Kratom Capsules (All Sizes)
30 Count
60 Count
100 Count
500 Count
125 Count (Minis)
250 (minis)
Kratom Powder
Kratom Powder (All Sizes)
30 Grams
60 Grams
100 Grams
500 Grams
1000 Grams (Choice Kilos)
Liquid Extracts
Liquid Extracts (All Flavors)
Green Apple (15 ML)
Double Green Apple (30 ML)
Red Vien (12 ML)
Maeng Da (12 ML)
Mitra Extracts
Mitra Extracts (All Flavors)
Mitra Burst
Capsule Extracts
2 Count
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