Wholesale Application - Banyan Botanicals

General Information

Full name Position billing address city

shipping address city

Wholesale Application

state

company

Please fill out all information that applies.

company website

billing address line two

zip/postal code

country

same as billing address

shipping address line two

state

zip/postal code

country

phone number

ext

fax number

email address

if applicable, other approved purchasers: how did you hear about banyan?

section 2

Business Information

Type of Business (check all that apply):

Individual health practitioner

spa

Wellness center

retail/health food store

yoga studio

school of ayurveda

manufacturer internet reseller distributor

Type of Practitioner (check all that apply):

does not apply

Doctor of Oriental Medicine

ayurvedic practitioner

Massage therapist/Bodyworker

Chiropractor

Medical Doctor

Naturopathic Doctor nurse Nutritionist

other

Osteopathic Doctor Yoga instructor/Therapist other

Certified Organic Herbs ? Sustainably Sourced ? Fairly Traded

800.953.6424 |

Ayurvedic Services and Treatments Offered (check all that apply):

does not apply

Marma therapy

Ayurvedic consultations

Shirodhara

Panchakarma

Swedana/steam

Ayurvedic massage

Herbal skin treatments

Use of Products (check all that apply):

Use with clients

Use in treatments

Resell to clients

Resell to general public

section 3

Professional and Business Credentials

Acceptable forms of credentials for Practitioners (please attach a copy of one of the following):

? Diploma ? Certificate of Completion ? State License

Wholesale Application

page 2

Netra basti Nasya Ayurvedic education Jyotish

Yoga instruction Meditation classes Pranayama instruction

Resell to other resellers Personal Use

For all other business types, please list your EIN number and attach a copy of your business license:

EIN Number

section 4

Internet Reseller Application

Wholesale accounts are intended for health centers and health practitioners that use products in their practice and/or for resale to their clients. Resale of Banyan products on the internet is prohibited without written consent from Banyan Botanicals.

Are you planning on selling Banyan Botanicals products on your website? If yes, please continue. If no, skip to section 5.

Web address(s) of site or sites you would like to sell products on

yes

no

target audience

Existing Cliental

general public

Existing Cliental

general public

Existing Cliental

general public

Approval as wholesale account does not imply permission to resell Banyan Botanicals products online. You will receive a separate notification informing you of your status as an internet reseller. Selling Banyan Botanicals products online prior to receiving this written approval is prohibited.

Certified Organic Herbs ? Sustainably Sourced ? Fairly Traded

800.953.6424 |

Wholesale Application

PAGE 3

SECTION 5

Wholesale Terms and Conditions

1. Minimum product order is $75.00. 2. All prices are subject to change due to market

fluctuations. 3. We accept MasterCard, Visa, Discover, and American

Express. 4. Upon credit approval, we o er Net 30 terms. 5. For non-credit customers, orders can be paid in

advance or shipped C.O.D. for an extra $12.00.

6. Overdue balances are subject to late payment charges of 1.5% per month (18% per annum).

7. Orders will only be shipped to current accounts in good standing.

8. Returned checks are subject to a $20.00 fee.

9. Approval as a wholesale account does not imply consent to resell our products on the internet.

If your account is approved to resell Banyan Botanicals products on the internet, the following terms and conditions will also apply:

10. Products may be resold on approved website(s) only.

11. Products may not be sold on any 3rd party sites such as Amazon or Ebay.

12. Products may not be sold for lower than the full retail price as listed on the Banyan Botanicals website.

13. Special promotions or sales that result in the per unit price of a product to be less than the Banyan Botanicals full retail price are prohibited.

14. If you o er free shipping on orders less than $100.00 you must add $2.00 to the full retail price of each product.

15. It is the reseller's responsibility to see that all California customers receive the proper Proposition 65 warning by either providing warnings on product labels, a warning on the invoice, or a warning on the website. If your site is approved, more specific details will be provided.

Violation of any of the above terms and conditions may result in the revocation of permission to sell Banyan Botanicals products online, loss of wholesale status and the termination of the account. All policies and conditions are subject to change without notice and at the sole discretion of Banyan Botanicals.

The new Banyan Affiliate Program pays a 20% commission for online referral sales.

Interested in learning more?

YES

NO

Agreement

I agree to adhere to Banyan wholesale terms and conditions. The information I am providing on this form and the credentials I have submitted are true and accurate.

SIGNATURE

DATE

Please submit in one of the following ways: Email to: wholesale@ Fax to: 505.857.0202 Mail to: Banyan Botanicals, 6705 Eagle Rock Ave N.E., Albuquerque, NM, 87113

Certified Organic Herbs ? Sustainably Sourced ? Fairly Traded

800.953.6424 |

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