Health Food 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 requirements.
Be a health-related business with a storefront.
Possess one of the following.
1. Resale License
2. Federal Tax Identification Number
Submit this application and fax relevant licenses or certificates to 561.575.5488.

Contact Information

Business Name

Phone

Fax

Mailing Address

City

Zip

Shipping Address

Shipping Add. (if different)

Zip

State

City

Business Information

Types of Business
Health Food StoreOther

Please Specify

Resale License

Federal Tax ID

Please list 2 business contacts of account suppliers as references

Contact 1

Phone Number

Contact 2

Phone Number

Please Specify

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