Dispensary Full Package
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Entity Name & DBA
Own or Lease Building
Square Footage
Estimated Sales for the next 12 Months
Build out Cost
THC Stock
Non THC Stock (CBD, Pipes, art for sale, etc)
Business Property (Computers, TV, Safe, Display Cases)
Additional Notes
Submit
Should be Empty: