GNOMAD Canna Co Vendors Application

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Contact infoGNOMAD Canna Co Hobbs, Tatum New Mexico contactus@gnoamdcannaco.com www.gnomadcannaco.com (575) 398-WEED

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Cannabis Product Vendor Registration

GNOMAD Canna Co is excited to work with you, your team and your cannabis derived THC product. We understand the importance of upholding high standards with our vendors and our customers, which is why we take great care in selecting the products that we sell. To ensure that every THC product meets all necessary quality control requirements and laws, please fill out this application completely and accurately. If you have any questions, don't hesitate to ask. We cannot accept any applications that haven't been completed. We look forward to collaborating with you!

Please complete form below to become a vendor. If you have any problems please email us @ contactus@gnomadcannaco.com

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Organization/Business Name* This field is required.

Legally licensed Name

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Established Date* This field is required.

Date

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Point of Contact* This field is required.

First Name

Last Name

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Phone Number* This field is required.

Area Code

Phone Number

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E-mail* This field is required.

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Role in Company* This field is required.

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Company Contact Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Tell us your story, Where did it all begin, What is the heart of your company. Our Customers are looking for Brands that help them reach their goals, and one way to do that is through your story. Tell us about your team, future, website and packaging.* This field is required.

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Do you provide any display and/or informational materials?* This field is required.

YESNO

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Please Describe * This field is required.

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Do you supply product samples?* This field is required.

YESNO

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Please Describe * This field is required.

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Website

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Instagram

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Facebook

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FED EIN* This field is required.

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Are you tax exempt?* This field is required.

YESNO

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Upload NTTC* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Insured?* This field is required.

Yes

No

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Insurance Provider* This field is required.

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NMCCD Licensed?* This field is required.

Yes

No

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License Number* This field is required.

NMRLD#

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License NumberAdditional Licenses

NMRLD#

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Where did your product originate?* This field is required.

Grown inhouse under our licensed #Purchased from NMCCD Producer/Manufacture (White label)

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GNOMAD Canna Co holds strict quality control guidelines and chooses to only do business with reputable Cannabis Companies throughout the state. List any/all NM producers and their NMCCD# you may use to produce your product.

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NMCCD Producers Info* This field is required.If license is different from above distribution License #

Producers Name

License #

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Material NMCCD Producers/Manufactures Info* This field is required.

Producers Name

License #

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Material NMCCD Producers/Manufactures InfoAdditional space

Producers Name

License #

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Material NMCCD Producers/Manufactures InfoAdditional Space

Producers Name

License #

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Send Pictures of your product for social media and packaging approval * This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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I hereby affirm that all the information provided in this application is accurate and true to the best of my knowledge. I understand that by submitting this application, I agree to abide by all laws, regulations, and policies set forth by the State of New Mexico and GNOMAD Canna Co. I further acknowledge that the completion of this application does not guarantee my acceptance as a vendor. I understand that GNOMAD Canna Co may require additional information or documentation prior to making a final decision. I certify that I have read and fully understand all policies and procedures of GNOMAD Canna Co.

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Date* This field is required.

Date

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Name* This field is required.

First Name

Last Name

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Company Representative Signature* This field is required.

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