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Secure Internal Ordering System
Wholesale
Application Form
Authorized Sales Representatives Only Submit wholesale orders, licenses, and business information securely.
Wholesale Order Form
Email
Legal Name of Licensed Entity
License Number(s)
Upload License
Choose File
Billing Address
Physical Facility Address
Purchasing POC Full Name
Purchasing POC Phone Number
Purchasing POC Email Address
Billing POC Full Name
Billing POC Phone Number
Billing POC Email Address
Intake / Transport POC Full Namee
Intake / Transport POC Phone Number
Intake / Transport POC Email Address
Product Order Request
- Select -
Pre-Rolls
Flower
Amount (lbs)
Preferred Payment Method
- Select -
ACH
Wire Transfer
Cash
Other
Additional Notes
Submit Wholesale Application
Please complete all required business and licensing information to submit your wholesale order request.
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