## 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*