SAM's Apothecary Wholesale Application
Please fill out this application for consideration. We will get back to you that we have received it, and then again when a decision has been made. Thank you for your support!
Legal business name & DBA
Business Website (or enter "NA")
Business Facebook Page (or enter "NA")
STATE Business License #
STATE where business license issued from
Reseller Permit Number (OR "SAME AS LICENSE)
Your Position (If not the owner, manager, or buying manager, please also enter their name and contact number in the next question)
Owner or manager contact information if you are not that person.
Your Phone Number
Billing Address (### & Street)
Billing Address (City, State, & Postal Code)
Shipping address IF DIFFERENT THAN BILLING ADDRESS
Special Shipping / Delivery Instructions
What interests you about carrying the SAM's Apothecary line of products?
Please acknowledge that White Sage sourcing is important, and that you strive to provide only ethically sourced White Sage.
I don't care (your application will be discarded)
I understand, and we already do this
I didn't know that, but will take it into consideration AND work towards ensuring these best practices
Please acknowledge that Palo Santo is over harvested and not ethical.
I don't care (again, your application will be discarded)
I understand, we do not offer Palo Santo
I didn't know that, but will work towards discontinuing Palo Santo products.
What is the population of your town/county/market area?
How many business within 50 miles do what you do?
Please understand that if there is another business within the 50 miles that already carries SAM's products, your application will be further reviewed, and potentially held until such time as they either no longer carry them, or our exclusivity policy is changed.
All of our products are infused with Reiki healing energy. Time, effort, and love goes into every batch of every product. Please acknowledge that our products aren't 'just another product on the shelf'.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of SAM's Apothecary LLC.