» My account

If you're a distributor, do not fill out this form - Please call our Customer Service Team at 1-800-983-3326 to have your account created for you. Stores with multiple locations don't qualify as a distributor.

Please Note: This form is for Retailer registration only.

Customer Service: 1-800-983-3326

Hours: Monday through Friday 8AM-5PM Mountain Standard Time (excluding major holidays)

Company Name*

Account Type *

Tobacco License Number

State Tax ID (Resellers Permit)

Primary Contact

First Name*

Last Name*

Business Phone*

Mobile Phone

What is your direct phone number?

Your Date of Birth*

We require this to ensure you're over 21.

Addresses

Corporate and Shipping (only Corporate is required if the others match). Please input your address exactly as it's listed on the USPS.com website.

Company Address*

Street Address*

Address Line 2

City*

State / Region / Province*

Postal / Zip Code*

Country*

Shipping Address (if different than Company Address).

Shipping Address

Street Address

Address Line 2

City

State / Region / Province

Postal / Zip Code

Country

Authorization & Notes

By clicking 'Submit' on this page, you're agreeing to the following: I (we) understand that this authorization will remain in full force and effect until I (we) notify Drip Drop Distro LLC in writing, by phone, or email that I (we) wish to revoke this authorization. I (we) understand that Drip Drop Distro LLC requires at least three business days prior to notice in order to cancel this authorization.

Special Notes

Is there anything you'd like us to know?

Email address *

Password *

User Type *

Federal EIN *

Confirm password *

Your personal data will be used to support your experience throughout this website, to manage access to your account, and for other purposes described in our privacy policy.

Primary Contact

Addresses

Authorization & Notes

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