Company name*

First & Last Name*

Email*

Street address*

City*

State/Region*

Phone number

Where can we find you online?*

What is your Industry?*

Grocery

Hospitality/Foodservice

Gift Baskets/Gift Subscription

Boutique Store

Other

How did you hear about Copper Cow Coffee?*Please SelectSocial MediaRetail StoreShark TankTradeshowWord of MouthSearch ResultOther

I agree that I will not resell any items I purchase from Copper Cow Coffee on third party resellers (Amazon, Ebay, Etsy, etc)*

Accept

Decline

I'd like to receive upcoming information regarding promotions & new products from Copper Cow Coffee Wholesale. *

YES

NO

Please attach documentation that verifies you are a business (i.e. EIN, Resale Certificate, Business Certificate)*

Anything else you feel we should know about your business?

Submit