Authorized Dealer Application Form

Please complete the form below to apply to Brite’s authorized reseller program. Licensed dispensaries, delivery services, or distributors only.

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Name *

First

Last

Email *

Mobile Phone *

Company name *

Address *

Address Line 1

City

State

Zip Code

Website / URL *

Company Type *

Number of Locations *

CA License # *

Brite Labs is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you: *

I agree to receive other communications from Brite Labs.

In order to provide you the content requested, we need to store and process your personal data. If you consent to us storing your personal data for this purpose, please tick the checkbox below. *

I agree to allow Brite Labs to store and process my personal data.

Name