Jasmine Pearl Tea Co.

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Name of Business Owner / Main Contact *

Name of Business *

Email Address *

Phone Number

Website

Mailing Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Shipping Address (If Different)

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

What state is your business registered in? *

Federal Tax ID Number

Example: XXXXXXXXX (9 digits, no dashes or spaces).

Tell us about your tea needs

How did you hear about us?

Business Type

Wholesale Account Application