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Wholesale Registration

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Partner with Lazarus Naturals and sell our products directly to your customers. Fill out the following form to get started.

First Name

Last Name

Job title (your role or position)

Company Name

Website (optional)

Phone

Email (confirm)

Password Strength: No Password

Password

Password (confirm)

Address (Line 1)

Address (Line 2)

City

Country

State

ZIP

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How do you conduct business?

Brick and Mortar

Online

This is a required field

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What kind of business do you have?

Practitioners & Therapists

Natural Food

Conventional Grocery

Pharmacy

Convenience/Smoke Shop

CBD Specific

Dispensary/Recreational Marijuana

Pet

This is a required field

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Resale Certificate / Business License

If you are in NH, OR, MT, AK or DE, please upload your Business License. Otherwise, please upload your Resale Certificate.

Not sure which document to send? View sample

Drag and drop files here

Allowed file types are .jpg, .jpeg, .png, .tif, .tiff and .pdf

Please upload a resale certificate or business license.

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Review

Please review and submit or go back to make changes.

Name
Job Title
Company Name
Website
Phone
Email
Address
City
State
Zip
How you conduct business
Type of business
Resale Certificate / Business License

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