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Home Wholesale Account Application

Wholesale Account Application

Thank you for your interest in opening an wholesale account with Amazing Herbs. Applications must be accompanied with a copy of business license and/or a copy of resale certificate. Please fax to 770-982-0273 or email to info@amazingherbs.com. Missing information may delay approval process. For additional information, you may contact us by phone at 1-800-241-9138.

Account Information

First Name:
Last Name:
Email Address:
Choose a password:
Re-enter password:
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Company Information

Is your company : Sole Prop. Corporation LLC Partnership
Company Name:
First Name:
Last Name:
Company Federal Tax ID #:
Website:
Company Phone # :
Does your company function as a retail location? : Yes No

Shipping Address

First Name:
Last Name:
Company:
Optional
Street Address 1:
Street Address 2:
Optional
City:
Zip Code:
State:
Country:
Phone Number:
  888-888-8888

Billing Address

Same as Shipping Address