Register | Hemp Supply Prime

Your Name *

Your Email *

Phone Number *

Company Name *

Company EIN

Resale Certificate

Business Address *

City *

State *

Zip *

Product of Interest (Check all that apply) *

Extracts

Gummies

Flower

Vape

Pre-Rolls

Terpenes

Other

Area of Focus (Check all that apply) *

Bulk

Retail

Manufacturing

Co-Packing

Distribution

Other

Estimated Monthly Purchase Volume *

$10K - $25K

$30K - $50K

$60K - $100K

$100K+

Who Is Your Current Supplier *

How did you hear about us? *

Other questions or comments about your business or needs? *

Salesperson

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