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Company Legal Name
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Sole Proprietorship
Business d/b/a/ Name
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What Type of Business Are You?
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Barbecue Supply Shop
Butcher Shop
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Company Billing State
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Company Billing Zip Code
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Year Established
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How Long at Current Address? (years)
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Federal Tax ID # (or Soc. Sec. # for Sole Proprietorship)
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State Sales and Use Tax Resale Certificate
Company Shipping Address Line 1
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Company Shipping Address Line 2
Company Shipping City
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Company Shipping State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
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New Jersey
New Mexico
New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tenessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
Company Shipping Zip Code
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First Name of Person Responsible for Placing Orders
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Last Name of Person Responsible for Placing Orders
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Email
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Confirm Email
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Phone Number (xxxxxxxxxx)
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Are You Currently Selling Barbecue Pellets?
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Yes
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What Brands of Pellet Grills do You Currently Sell?
Traeger
PitBoss
ReqTeq
Asmoke
Camp Chef
Z Grills
Weber
Oklahoma Joes's
Louisiana
Cuisinart
Memphis
Green Mountain
What Brands of Wood Pellets Do You Currently Sell?
Traeger
Pit Boss
Bear Mountain
Kingsford
Lumberjack Pellets
CookinPellets
Weber Pellets
Green Mountain
Camp Chef
Other
Other Brands of Wood Pellets
Do you have a loading dock?
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Do you require a liftgate for deliveries?
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Name of Accounts Payable Contact
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Email of Accounts Payable Contact
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Confirm Email of Accounts Payable Contact
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Would You Like to Request Net 30 Day Terms?
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