Become a Wholesaler

Name of Company *

Business Name (if different from Company Name)

City *

State *

Zip Code *

Phone Number *

Company Website *

Type of Business *
---RetailOnlineBar / RestaurantDistributorOther

Number of Locations *

Total Annual Sales *
---Less than $100,000$100,001 - $500,000$500,001 - $2 million$2 million - $5 millionMore than $5 million

Do you currently sell Jerky or other snack meats? *
---YesNo

State Reseller Certificate Number *

State of Issue *
---AL-AlabamaAK-AlaskaAZ-ArizonaAR-ArkansasCA-CaliforniaCO-ColoradoCT-ConnecticutDE-DelawareFL-FloridaGA-GeorgiaHI-HawaiiID-IdahoIL-IllinoisIN-IndianaIA-IowaKS-KansasKY-KentuckyLA-LouisianaME-MaineMD-MarylandMA-MassachusettsMI-MichiganMN-MinnesotaMS-MississippiMO-MissouriMT-MontanaNE-NebraskaNV-NevadaNH-New HampshireNJ-New JerseyNM-New MexicoNY-New YorkNC-North CarolinaND-North DakotaOH-OhioOK-OklahomaOR-OregonPA-PennsylvaniaRI-Rhode IslandSC-South CarolinaSD-South DakotaTN-TennesseeTX-TexasUT-UtahVT-VermontVA-VirginiaWA-WashingtonWV-West VirginiaWI-WisconsinWY-WyomingDC-District of ColumbiaAS-American SamoaGU-GuamMP-Northern Mariana IslandsPR-Puerto RicoUM-United States Minor Outlying IslandsVI-Virgin Islands, U.S.

Contact First Name *

Contact Last Name *

Contact Phone Number *

Contact Cell Number

Salesperson First Name

Salesperson Last Name