Wholesale Registration Form

First Name *

Username *

Last Name *

Phone *

Email *

Country *United StatesCanadaUnited KingdomAustraliaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzechiaDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyKazakhstanLatviaLiechtensteinLithuaniaLuxembourgMaltaMoldovaMonacoMontenegroNetherlandsNorth MacedoniaNorwayPolandPortugalRomaniaRussiaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandTurkeyUkraineVatican CityThailand

Address 1 *

City *

State *

Postcode *

Company Name *

Website (optional)

Social Links (optional)

Q1: How long has the business been operating? (Years) *

Q2: Tell us what type of store you run? *Seed BankHydro StoreBoth

Q3: Do you sell Online, In-Store, or both? *Online OnlyIn-Store OnlyBoth

Please upload your logo here. (this must be in high resolution)

Tell us more about your business *

Accept that we need to contact you via email & SMS *I accept that Elev8 will need to contact me via email & SMS to discuss my account, orders and provide wholsesaler updates.