Vendor Onboarding – KORcannabis

Company Name *

DBA *

AP Contact First Name *

AP Contact Last Name *

AP Contact Email *

AP Contact Phone *

Physical Address *

Suite, Bldg, etc.

City *

State *

Zip Code *

My preferred payment method is: *

Bank Name *

Name on Bank Account *

Account Type *

Mailing Address if Different from Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Routing Number *

Account Number *

Please upload your W9 *

Click or drag a file to this area to upload.

Website URL