Wholesale New Customer Registration Form

Wholesale Catalog Inquiry Form

To apply for an wholesale account please fill out the following form.
Business Name*
Years in Business*
Federal Tax or EIN Number
Phone Number*

Area CodePhone Number
Type of Organization*

IndividualPartnershipCorporationNon ProfitGovernementOther
Type of Business*

ManufacturerTeashopHotel / MotelRestaurantGift ShopOnline RetailerOffice distributorRetail DistributorWholesale DistributorCoffee ShopRoastersOther
Buyer Contact*

First NameLast Name
E-mail*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What Products were you interested in?

Loose Leaf Teas & HerbsCustom BlendsIced TeasPyramid Tea BagsAccessoriesOther
How did you hear about us?
ReCaptcha:*
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Wholesale Catalog Inquiry Form