Retailer and Services Form

Fill out the form below to become a SLAPS! retailer or to inquire about CANNAWORLD services

Which describes You? (Check all that apply)

I want to become a SLAPS! retailer.

I'm interested in CANNAWORLD services.

License Name

DBA

MN Tax ID #

EIN #

OCM License #

License Expiration Date

Cannabis License Type

Shipping Address

Delivery Special Instructions

First name (Primary Contact)

Last name (Primary Contact)

Primary Contact's Title/Position

Phone

Email

Accounting Contact Name

Accounting Contact Phone

Accounting Contact Email

Preferred Payment Method

ACH

WIRE TRANSFER

CASH

OCM License

ST3 Exemption (Signed)