B2B Account Request Submission Form

APPLY FOR ACCOUNT
Business Name:*
Number of Stores:*
Upload Business Permit/License

Please supply a valid license or permit that corresponds to the business or corporate address listed on this application.
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Upload Resale License / Sales Permit*

Please supply a valid license or permit that corresponds to the business or corporate address listed on this application.
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Shipping Street 1*
Shipping Street 2
Shipping City*
Shipping State*
Shipping Zip*
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Business Website or Facebook Page
Which of the below options best describe your business?*

BrandRetailEcommerceResellerManufacturerDistributor
Where did you hear about us?*

ExpoEmailBusiness Development RepReferral (Word of Mouth)Store VisitSocial Media (Facebook, Reddit, Insta, TikTok, X)Google SearchDistributorIndustry Event / Party
Upload a Picture of Your Store Interior

(Flagship Location if you have multiple storefronts)
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Upload a Picture of Your Store Exterior

(Flagship Location if you have multiple storefronts)
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Should be Empty:

APPLY FOR ACCOUNT