Vendor Application – Street Legal PR

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Vendor Application

Interested in selling our products? Fill out the form below to apply.

Your Position*

First Name*

Last Name*

Phone Number*

Extension

Email*

Company Information

Please fill out all the information on your company.

Organization Type*

Company Name*

Company Website*

Address*

Address 2

City*

State*

Zip Code*

EIN Number*

Tax Exempt*

Sales Certificate #

Billing Contact First Name*

Billing Contact Last Name*

Billing Number*

Billing Ext.

Billing Email*

Select Your Sales Channel*

Online Warehouse Retail Store Amazon

Estimated Monthly Sales*

Social Media

Please provide your company's social media.