I NEED A WHOLESALE ACCOUNT!
WHOLESALE INQUIRY
NAME
*
First Name
Last Name
EMAIL
*
MESSAGE
*
PHONE
*
(###) ###-####
(###)
###
####
STORE NAME
# OF LOCATIONS
*
1
2
3
4
5
6
7
8
9
10+
TAX ID
*
CITY
STATE/PROVINCE
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
WEBSITE
ESTIMATE INITIAL ORDER SIZE
0-100 UNITS
100-500 UNITS
500-1000 UNITS
1000+ UNITS
TYPE OF WHOLESALE ACCOUNT
RETAIL, DISTRIBUTION, OR BOTH?
RETAILER (STOREFRONT)
RETAILER (ONLINE)
DISTRIBUTOR
WHAT PRODUCTS ARE YOU INTERESTED IN?
VAPE
CBD
OTHER
HOW DID YOU HEAR ABOUT US?
ANY OTHER QUESTIONS OR COMMENTS?
FEIN
*
Checkbox
*
I AGREE TO EMAIL MY BUSINESS LICENSE, TOBACCO LICENSE, AND STATE TAX PERMIT TO SALES@BADDRIPLABS.COM UPON THE COMPLETION OF THIS FORM
Thank you!
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