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Approval-Only Entry
Retailer Onboarding Engine
This form creates a pending application only. It does not create an active buying account.
Stage 1: Profile Data
First Name
Last Name
Title
Business Email
Phone
Stage 2: Company Data
Exact Legal Entity Name
DBA
Website URL
Monthly Buying Volume
Under $5,000
$5,000 - $10,000
$10,000 - $25,000
$25,000+
Billing Address
Shipping Address
Stage 3: Tax & Compliance
Federal Tax ID / EIN
State of Incorporation
Resale Certificate No.
Upload Resale Certificate PDF/JPG/PNG Max 5MB
Stage 4: Business Classification
Independent Grocery
E-commerce
Logistics / 3PL
Omnichannel
Other
Notes
Submit for Manual Review
Already Approved?