Consignment Application
After you fill out this consignment application, we will contact you to go over details and availability before we approve you and send you a digital contract to DocuSign.

After the contract is signed, we'll ship your initial shipment of bottles along with in-store menus.

If you would like faster service and direct information on current stock and pricing please contact us at
(206) 408-1120 or consignment@captiveclouds.com
Email address *
Sales Rep (if applicable)
Are you a new or existing customer?
Which Brands would you like to carry? *
Required
What nicotine strengths would you like to stock? *
Required
Contact info
Your name (First, Last) *
Your answer
How many years in business? *
Business Legal Name *
Your answer
Business Tax ID or Business License *
Your answer
Business Address *
Your answer
Business City *
Your answer
Business State *
Your answer
Business Zip *
Your answer
Phone number *
Your answer
Business E-mail (if different than personal above) *
Your answer
Business Website (url)
Your answer
Business YELP (url)
Your answer
Business Instagram (url/@username)
Your answer
Business Facebook (url)
Your answer
Preferred contact method *
Required
Sample Nicotine Preference (included with first consignment shipment) *
Questions and comments
Your answer
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This form was created inside of Artisan Clouds, LLC.