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Rishi Tea Wholesale Registration

Please complete the following form to request wholesale information. A Rishi representative
will contact you shortly. Required fields are yellow. 

Your Company Information:

Are you an existing Rishi Tea Reseller?: 

No Yes

Your Company Name: 

Type of Business 

Reseller Permit Number: 


A resellers permit number will be required to set up a wholesale
account. If you do not know your number or if you have applied but
not yet received it, please enter TBD.

Your Primary Contact & Billing Information:

First Name: 

Middle Initial: 

Last Name: 

E-Mail: 

Confirm E-mail: 

Address: 

City: 

State: 

Zip: 

Phone: 

Area Code:  Number: 

Fax: 

Area Code:  Number: 

Your  Website: 

http://

Your Primary Ship To Information:

Check if Ship To is Same as Bill To:

Ship To Company Name: 

Ship To Address: 

Ship To City: 

Ship To State: 

 Ship To Zip: 

Ship To Phone: 

Area Code:  Number: 

Comments: