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New Retail Partner Sign-Up Form

SECTION 1 — Store Information

Delivery Address

SECTION 2 — Primary Contact

SECTION 3 — Ordering & Delivery Preferences

Preferred Method of Ordering
Email
Phone
Online Portal
SLGA Direct
3rd Party Distributor Portal (Set the Bar, etc)
Other

SECTION 4 — Payment & EFT Information

Preferred Payment Method
EFT
Credit Card
Cheque

EFT BANKING INFORMATION

Billing Address (If Different from Mailing Address)

SECTION 5 — Product Interests

Which products are you interested in carrying?

SECTION 6 — Marketing & Placement Opportunities

So we can follow you and tag you in all promos and events we run

Are you open to / do you have partnership options for any of the following?

SECTION 7 — Create Account / CTA

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