## Wholesale Application

### BUSINESS APPLICATION

Interested in selling MATI?

Looking to order MATI in bulk to fuel your employees?

**Fill out the following form and we'll get back to you asap!**

Questions about the program? Send an email to [order@matienergy.com](mailto:order@matienergy.com)

### Application Form

- **First Name***
- **Last Name***
- **Job Title***
- **Email***
- **Phone***
- **Business Name***
- **What type of business do you have?***
  - Convenience store
  - Office
  - Food service
  - Bar / bottle shop
  - Gym
  - Drugstore
  - Vending
  - Hotel
  - Specialty Grocery
  - Other
- **Who is your preferred distributor?***
  - US Foods
  - Vistar
  - Capitol Coffee
  - Artisan Beverage
  - Reinhart Food Service
  - UNFI
  - KeHe
  - N/A - prefer to buy directly from MATI
- **Are you looking to resell MATI at a physical retail location?***
  - Yes
  - No
- **State Resale Number**
- **Are you interested in carrying MATI in multiple locations?***
  - Yes
  - No
- **Please attach a list of all locations product will be sold.***
- **Are you looking to purchase MATI in bulk to fuel your employees / clients?***
  - Yes
  - No
- **How many employees does your business have?***
- **Shipping Address***
- **City***
- **State***
- **Zip / Postal***
- **Corporate Billing Contact (name)***
- **Corporate Billing Email***
- **Billing Address***
- **City***
- **State***
- **Zip / Postal***
- **How did you hear about us?***
- **Is there anything else you would like us to know?**

**Submit**