Mail Order Retailers

Account Application Form

Thank you for choosing to open an account with Garden of Life. To establish an account with us, we ask that you:

Meet Garden of Life's minimum order requirement of $300.
Have an existing health-related website or catalog.
Possess one of the following:
1. Resale license
2. Business license
3. Federal tax identification number
Provide 2 existing business references.
Submit this application and fax relevant license or certificate to 678-808-8153.

Contact Information

Business Name

Phone

Fax

Mailing Address

City

Zip

Shipping Add. (if different)

City

Zip

Business Information

Types of Business
WebsiteCatalog

Website Address

Reffered By: (How di you hear about us?)
MagazineInternetTrade ShowOther

Please Specify

Please list 2 business contacts of account suppliers as references

Contact 1

Phone Number

Contact 2

Phone Number

Method of Payment
All orders processed by Garden of Life will be billed via credit card or C.O.D.

IMPORTANT NOTE: Please do not submit your credit card information via this online form.
After submitting this form, you will be contacted by one of our customer service representatives to take your initial order and credit card information.

Accounts Payable Contact

Authorized Signature

By submitting this form, I Recognize And Accept The Conditions Shown Above And Certify That All Information Listed Is Correct And Accurate.

Submit