Name *

First Name

Last Name

Category of Business *

Small Groceria

Gift Box / Basket Co.

Cafe / Bakery / Restaurant

Brick & Mortar Boutique

E-Commerse Re-Seller

Real Estate & Similar Services

Goods & Services Production

Other - Please Expand

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Checkbox *

I acknowledge and understand that wholesale pricing means volume / bulk ordering and that there are minimum order requirements in place that is to benefit the pricing structure of a wholesale program.

I acknowledge and understand that payment terms are due on receipt of invoice and prior to shipping And that credit card payments may incur a fee above and beyond the cost of product and cost of shipping.

I acknowledge and understand that any information received and or any aspect of Northern Fields as a business are subject to updates, inclusions and exclusions with respect to, but not limited to supply chain issues, ingredient availability and costs.

I acknowledge and understand that I will not be repacking any bulk product without pre-arranged consent and a written contract to do so as there are food safety legalities and licensing requirements that must be adhered to for traceability best practises.

I acknowledge and understand that the information obtained within the relationship with Northern Fields is considered proprietary and original to Northern Fieldsand is also considered trademark protected information not to be shared outside of the confidentiality of the intended recipients nor shared with potential competitors of Northern Fields.