Wholesale Application

Thank you for your interest in partnering with 22 Salute Spirits & Coffee 'With A Purpose'™. To help us expedite the process of setting up your account, placing your order, and ensuring prompt delivery of your products, please complete the new client information form below. We appreciate your collaboration in this crucial mission to support mental health and reduce the number of suicides among Veterans and First Responders.

Please review your information carefully before submitting. Once we receive your completed form, a member of our team will reach out to you to finalize your account setup and assist with placing your order.

Thank you for choosing to partner with 22 Salute Spirits & Coffee 'With A Purpose'™ and joining us in making a meaningful impact.

COMPANY NAME:

DBA (IF ANY):

Business Type

Which products would you like to sell?

Billing Address:

Business Suite:

City:

State:

Zip Code:

Billing Country:

Billing Contact First Name:

Billing Contact Last Name:

Billing Phone Number:

Billing Instructions (if any):

LICENSES

Liquor License No.:

State:

Sales Tax Permit No.:

(Attach signed copy of Retail Certificate Form)

DELIVERY INFORMATION

Delivery Address:

Shipping Suite:

City:

State:

Zip Code:

Shipping Country

Delivery Days:

Delivery Times:

Delivery Notes:

Your Name:

Title:

Your Email:

Date