Wholesale Customer Application Page

Coming soon

Welcome to Chickadee Farm Herbs.

If you would like to become a wholesale customer and you are a business, please fill out the following form. We will review your application and get back to you with a password for the wholesale portion of our website.

Download our full Wholesale Policies and Price List (PDF). Includes packaging details, shipping rates, credit terms, and ordering guidelines.

Wholesale Application Form

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Name *

First

Last

Business Name

Phone number *

Email *

Website

Business Address *

Address line 2

Town/City *

Postal Code *

Shipping Address (if different from business address)

Shipping Address line 2

Shipping Town/City

Name and Name

Shipping Postal Code

Reference 1: Bank Name and contact information

Fill out this part if you would like terms (30 days) with Chickadee Farm Herbs. References Chickadee Farm Herbs Ltd. has permission to contact.

Reference 2: Supplier Name and contact information

Fill out this part if you would like terms (30 days) with Chickadee Farm Herbs. References Chickadee Farm Herbs Ltd. has permission to contact.

Reference 3: Supplier Name and contact information

Fill out this part if you would like terms (30 days) with Chickadee Farm Herbs. References Chickadee Farm Herbs Ltd. has permission to contact.

Signature: *

I/We agree to the terms and conditions set out in the Chickadee Farm Herbs Ltd. Wholesale Price List.

Submit