JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Real Mushrooms Reseller Application
Real Mushrooms is seeking high quality retailers to partner with to spread the word of real mushrooms. To read more about us, see this blog post:
https://www.realmushrooms.com/medicinal-mushrooms-from-farm-to-table-the-real-mushrooms-story/
If you believe you fit the bill, please fill out the form below with your business information.
Resellers on 3rd party online marketplaces like Amazon and eBay will be ignored.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Full Business Name
*
Your answer
Business Type
*
Corporation
LLC
Sole Proprietor
Other:
Contact Name
*
Your answer
Contact Position
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Website
Your answer
Address
*
Your answer
Address (secondary)
Your answer
City
*
Your answer
State/Province
*
Your answer
Country
*
Your answer
Zip/Postal Code
*
Your answer
Where would you sell our products?
*
Online
Physical Storefront
Other:
Required
How many locations do you have?
*
Your answer
Do you sell on any 3rd party marketplaces? (Amazon, eBay, Walmart, Jet, etc.)
*
Yes
No
Why are you a good fit for Real Mushrooms?
*
Your answer
Comments
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Nammex.
Does this form look suspicious?
Report
Forms