Georgia Mushroom & Supply Co. — Wholesale Account Setup + Credit Terms Application

Georgia Mushroom & Supply Co. — Wholesale Account Setup + Credit Terms Application

Set up a wholesale account for fresh specialty mushrooms, scheduled delivery, invoicing, and approved payment setup with Georgia Mushroom & Supply Co.
Section A — Business Account Information
Legal Business Name
DBA / Restaurant Name
EIN
Business Type

Other
Main business phone
Please enter a valid phone number.Format: (000) 000-0000.
Main email
example@example.com
Billing address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Is delivery address the same as billing address?
Delivery address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Section B — Accounts Payable + Invoicing Setup
AP contact name
AP email
example@example.com
AP phone
Please enter a valid phone number.Format: (000) 000-0000.
Statement email, if different
example@example.com
Is a PO required?
Invoice submission method

Other
AP portal / invoice notes
Special billing instructions
Section C — Ordering + Delivery Contacts
Primary buyer / chef
Buyer email
example@example.com
Buyer mobile
Please enter a valid phone number.Format: (000) 000-0000.
Preferred order day/time
Authorized buyers
Delivery days / receiving window
Receiving instructions
Delivery contact name
Delivery contact phone
Please enter a valid phone number.Format: (000) 000-0000.
Section D — Product / Orders
Product interests

Other
Expected weekly volume/lbs
Standing order request
Section E — Order Minimums / Delivery

GMSC delivers on approved routes and confirmed schedules. Minimums and delivery fees protect harvest planning, cold-chain handling, route efficiency, and product quality.
Delivery / Pickup preference

Other
Delivery Minimums + Fees

GMSC delivers on approved routes and confirmed schedules. Current starting guidelines are:

Farm pickup: $75 minimum, no delivery fee.
Local scheduled delivery: $150 minimum, $25 delivery fee under $250, free delivery at $250+.
Regional scheduled delivery: $250 minimum, $45 delivery fee under $500, free delivery at $500+.
Atlanta scheduled route: $400 minimum, $75 delivery fee under $750, free delivery at $750+.

*Distributor, bulk, off-route, rush, emergency, multi-stop, or special delivery: quoted and approved by GMSC in writing.

**Delivery eligibility, fees, and free-delivery thresholds depend on route, order size, receiving window, account approval, and operational capacity. GMSC may update delivery minimums, route availability, and delivery fees with notice.
***Delivery zones are determined by GMSC based on distance from Carlton, Georgia, active route schedules, route density, traffic, receiving windows, and account volume. GMSC will confirm each customer’s delivery zone after account review.
Section F — Payment Setup

New accounts normally begin as COD / due on delivery or pre-approved electronic payment. Credit terms are not automatic and must be approved by GMSC in writing.
Requested terms

Other
Requested account limit

Other
Preferred payment method

Other
Payment notes
Do not write or submit card numbers or bank account numbers in this form. GMSC will provide a secure payment link or separate authorization form if needed.
Section G — Certification + Signature
Authorized signer name
Title
Customer email
example@example.com
Signature
Date

MonthDayYear
Date
*Submission does not guarantee account approval, delivery eligibility, product availability, credit terms, or standing order allocation. GMSC will review your submission and confirm approved account status in writing.
Should be Empty:

Georgia Mushroom & Supply Co. — Wholesale Account Setup + Credit Terms Application

Section A — Business Account Information

Section B — Accounts Payable + Invoicing Setup

Section C — Ordering + Delivery Contacts

Section D — Product / Orders

Section E — Order Minimums / Delivery

Section F — Payment Setup

Section G — Certification + Signature