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Food Service Application

Please allow 3-5 business days for your application to process.
Your Company Name *
Email Address *
Tax ID *
DUNS #
State of Incorporation *
Resale License # *
How were you referred to Barrington Tea?
Your Name
Your Name *

First

Last
Company Billing Address (No P.O. Boxes!)
Address line 1 *
Address line 2 *
City *
State *
Zip Code *
Billing address and Shipping address are the same *

Yes No
Company Shipping Address
Address line 1 *
Address line 2 *
City *
State *
Zip Code *