Growers Trust Distributor Application
Please be aware that completion of a Distributer application does not guarantee your acceptance as a Growers Trust reseller. All information we receive is kept confidential and safe.
* Required
Company Name
*
This is a required question
Date Business Started
*
You can give a rough estimate if you don't remember the exact date.
This is a required question
Type of Business
*
C-Corp
S-Corp
LLC
Sole Proprietor
Partnership
This is a required question
Tax ID #
*
EIN or SSN if Sole Proprietor
This is a required question
Name of Contact
*
The contact person we should contact about this account
This is a required question
Shipping Address
*
The Address that you will be a distributor at and that we will ship wholesale products to.
This is a required question
Business Phone Number
*
This is a required question
Business Fax Number
This is a required question
Email Address
*
This is a required question
Website
This is a required question
What type of business do you have?
This is a required question
Agreement
By sending in your information you agree that we can contact you to provide application status updates to you. At the time we receive this request to become a distributor we will send you via email our full distributor terms and conditions and will require your signature before acceptance.
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