Equator Coffee Roasters - Wholesale Intake Form

Contact

Weekly Order Email

ORDER CONTACT NAME * Email Address * Phone Number *

Billing / Invoice

BILLING/INVOICE CONTACT NAME * Email Address * Phone Number *

Other Contacts

OTHER CONTACT NAME Email Address Phone Number

Are you Interested In:

Packaged/ Retail Coffee
Bulk Coffee
Both

Would you like to brew Equator coffee (drip, espresso, etc.)

No
Yes

If yes, what type of equipment will you be using?

MAKE MODEL

Payment Information

*For the first 6 months of business with Equator, payments must be made prior to order delivery/shipment. Terms can be negotiated after 6 months of steady payment. We accept the following forms of payment:

*
Cheque E-Transfer Direct Deposit CREDIT CARD

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Wholesale

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Business Information

Business Type