Sample Request Sample Request Form Company InformationCompany Name(Required)Company Website or Social Media PageName(Required) First Name Last Name Email(Required) Shipping Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone Number(Required)What industry does your business operate in?What types of stick pack products are you interested in sampling? Hydration - Juicy Orange - Bioavailable Salts Hydration - Ripe Raspberry - Bioavailable Salts D9 Unflavored - Unflavored - 5mg THC + 20mg CBD D9 Unflavored- Unflavored - 10mg THC + 10mg CBD D9 Ratio Line - Juicy Orange - 5mg THC + 20mg CBD D9 Ratio Line - Ripe Raspberry - 10mg THC + 10mg CBD D9 Ratio Line - Fresh Watermelon - 15mg THC + 15mg CBD D9 Premium - Pineapple Express - 25mg THC with 9mg CBD + 8mg CBG = Total 50mg + Live Resin Terpenes Do you currently sell functional beverages, supplements, or wellness products?select a responseYesNot yet, but we’re launching soonNoWhat best describes your business stage? Established brand expanding product line New business launching a product Exploring options / early stage Just curious Are you open to a quick discovery call?select a responseYesNoHow did you hear about us?select a responseReferralAdGoogle SearchTradeshowOther Δ
