PURCHASE ORDER SUBMIT INFORMATION TO REQUEST A PURCHASE ORDER FOR ONE OF YOUR SUPPLIERS. Purchase Order Spam protection, skip this field What is this Purchase Order for? Storage Sale Customer Existing Supplier? Yes No Don't worry! This information will only have to be entered once. (optional) Supplier Number: Contact Name: Company Name: Phone Number: State: (optional) Email: Website: (optional) https:// Products: Strain 1: QTY: Cost Per Pound: Do you have other products to drop off? Yes No Product 2: QTY: Cost Per Pound: Do you have more samples to drop off? Yes No Product 3: QTY: Cost Per Pound: Do you have more samples to drop off? Yes No Product 4: QTY: Cost Per Pound: Do you have more samples to drop off? Yes No Product 5: QTY: Cost Per Pound: If you are submitting more than 5 strains/samples, please complete this current form and submit another with your supplier number. (optional) Notes: IC Name: Email for Confimation you@gmail.com Received By: