Retailer and Landscape Professional Registration
Owner's Name: Business Name:
Mailing Address: Business Address:
City, State, Zip: City, State, Zip:
Email address: Cell Phone #:
Telephone: Fax Phone #:
Buyer Name: PO# Required?:
= Yes = No
Business Type:  
(please click one)  
Retail
Nursery> 		Landscape>
Contractor 		Wholesale
Nursery> 		General>
Contractor 		Plant
Broker> 		Other>
(comment)
Your License# (required): Have Resale # ?:
= Yes = No
Your Resale#:
(Note: Without a Signed Resale Card on File, Sales Tax Will be Added to All Purchases)

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