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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.
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* Required
Company Name
*
Your answer
Date Business Started
*
You can give a rough estimate if you don't remember the exact date.
Your answer
Type of Business
*
C-Corp
S-Corp
LLC
Sole Proprietor
Partnership
Required
Tax ID #
*
EIN or SSN if Sole Proprietor
Your answer
Name of Contact
*
The contact person we should contact about this account
Your answer
Shipping Address
*
The Address that you will be a distributor at and that we will ship wholesale products to.
Your answer
Business Phone Number
*
Your answer
Business Fax Number
Your answer
Email Address
*
Your answer
Website
Your answer
What type of business do you have?
Your answer
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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