Customer On-board Application
Please fill out this form to get started
Company Name *
Your answer
Phone Number
Your answer
Email Address *
Your answer
Your answer
Primary Contact Name *
Your answer
What type of business would you like to conduct with us? (Check all that apply) *
What type of business do you have? (Check all that apply)
If you answered 'Retail' above, how many stores do you operate?
Your answer
Country *
Your answer
Province/State *
Your answer
City *
Your answer
Product Grading of Interest (Check all that apply)
Product of Interest (Check all that apply)
Brands Interested in (Check all that apply)
If you answered 'Other' above, please state the 'Brand(s)' bellow
Your answer
Estimated Weekly Purchasing ($CAD)
Provision Method
If you selected 'Pickup/Organize', which courier will you be using?
Your answer
Thank You!
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