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Wholesale Registration
Tim van den Boog
2025-10-27T12:46:50-07:00
Wholesale Registration Form
Interested in carrying our products? Fill out the business info and credit application form below to get started!
Name
(Required)
First
Last
Title
(Required)
Business Name
(Required)
Legal Business Name
Email
(Required)
Enter Email
Confirm Email
Phone
Registered Company Address
(Required)
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Bank name
(Required)
Bank account Number
(Required)
Type of account
(Required)
Savings
Checking
Other
Shipping address
(Required)
Important! Fill out your shipping address here.
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Email Accounts Payable
(Required)
Fill out the email address that we send your invoices to.
Agreement
(Required)
1. All invoices are to be paid 30 days from the date of the invoice.
2. Claims arising from invoices must be made within seven working days.
3. By submitting this application, you authorize Authentic Indigenous Seafood to make inquiries into the banking and business/trade references that you have supplied.
I agree.
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