Wholesale Application

with Botanical Blends, LLC.

*Terms:
All fields must be filled. A valid email address is required. To place an order, fill this form out and an invoice will be emailed to you through paypal. Once the invoice has been paid, your order will be shipped. An initial minimum order of $50 is required. Currently, only Botanical Blends products are available at wholesale pricing. Thank you.

Your First and Last Name: (required)

Company/Organization/School: (required)

Shipping Address:

Street Address: (required)

City: (required)

State & Country: (required)

Zip/Postal Code: (required)

Contact Information:

Phone:

Your Email: (required)

Additional Information:

License or Tax ID Number:

Will you be selling our products online?

Comments:

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