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Account Application

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You will need to apply for a wholesale account before being able to view pricing and place orders from our catalog. Upon approval of your account, you will be able to view our entire catalog and place orders. Regulated wholesale customers may take 1-3 business days to be approved.

Business Information

Please provide some basic information about your business.
Legal Business Name *
DBA
Phone
Company E-mail *
Tax ID / EIN
Website
Contact Information

Please provide information so we can get in touch.
First Name *
Last Name *
Contact E-mail
Billing Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *
W-9 Form
Select File(s)
Nature of Business

Please answer the following questions regarding the nature of your business.
Business Type *
Are you a vendor? *

Yes No Do you want to sell products through Highlanders Distribution?
Do you have a license to purchase regulated wholesale products? *

Yes No
BCC/CDPH License Number? *

License Type? *

Medicinal Recreational Both

Do you work with bulk cannabis product or raw materials? *

Yes No

Is your company based in California? *

Yes No
Valid State License
Select File(s)

Valid Local License
Select File(s)

Valid Sellers Permit
Select File(s)

Valid ID for Business Owner
Select File(s)
Name on ID must match the business license.

Additional Information

Please let us know how you heard about us so we can properly tag your account.
How did you hear about us? *

Highlanders Distribution Representative Social Media Web Search (Google, Bing, etc.) E-mail Word of Mouth Other
Account Representative
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Business Information

Contact Information

Nature of Business

Additional Information

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Business Information

Contact Information

Nature of Business

Additional Information

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