Thank you for your interest in working as a wholesaler with Herbsmith!

Once we receive your information we will set up an account for you to have access to our offers exclusive to our wholesalers.

Name*

Business Name*

FEIN #*

Shipping Address*

Shipping Address(cont'd)

Country*

State

City*

ZIP Code*


Billing Address*

Billing Address(cont'd)

Country*

State/Providence

City*

ZIP Code*


Phone*(xxx)xxx-xxxx


Email(will be username)*

Password*


Website or Facebook Page

Tax Exemption Upload (For WI residents only)