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Customer Cannabis-Related Licensure

Please fill out each cannabis-related license held:

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Account creation is contingent upon our vetting process. Please complete all fields within this form and allow 1 business day upon submission for review of application. A member of our team will reach out to you within this timeframe. Thank you.

Buyer hereby represents and warrants that the information submitted herein is accurate and correct and the customer may be required to provide Kush Supply Co. (and or its affiliates) with a copy of any documents reasonably requested by Kush Supply Co. (or its affiliates) evidencing such qualification and authorization upon request.