Resale Tax ID# *

Read and Agree *

I have a brick and mortar storefront.

I will place and order every 90 days to keep my account active.

I will reach a bi-annual total of $1500 in order to maintain area protection for the Southern Trend line.

I understand that Licensed Arkansas collegiate line is not area-protected.

I understand that the minimum per-order amount is $300.

I understand that I must receive approval for each storefront I have or intend to add.

First Name *

Last Name *

Company Name 

Street Address *

Address Line 2 

Country and State *

United States (US)

Town / City *

Postcode / ZIP *

Phone Number *