Customer Application

Title*:

First Name*: Your first name is required

Last Name*: Your last name is required

Company* (Existing or anticipated name): Your company name is required

Email*: Your email address is required.

Street Address*: Your street address is required.

Street Address:

Country*: Your country is required.

State/Province*: Your state or proivince is required.

City*: Your city is required.

Postal/Zip*: Your postal or zip code is required.

Phone*: Your phone number is required.

Do you operate a business? *:

Are you planning to open a business? *:

What sort of business do you operate? *:

Do you have a business license number? *:

(EIN#, Federal ID#, GST#, HST#, VAT#, Resale License#, etc.)* Please note that we will require this number before you place your opening order.

How did you hear about Metropolitan Tea?:

Comments / Questions: