New Customer Pre-Registration Form

Please read carefully and accept the terms and conditions at the bottom of this form before submitting.

This pre-registration form is for wholesale customers only. The minimum wholesale order is C$300.00 per store visit

Name

First Second

Company

Your Email

Your Password

Phone No

Billing Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country / Region

Ship to Address (if different)

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country / Region

Please answer all questions

How did you hear about us?
Are you the business owner & buyer?
Do you have an account with us already?
How long have you been in business?
Do you have brick & mortar store?
What is your website address?
Do you sell online?
What percentage of your sales are online?
Do you sell or plan to sell on Amazon or Ebay in the next 24 months?
What kind of products do you sell?
What countries do you sell and ship to?

Further Comments

Supporting Document

I accept the Terms and Conditions