Retailer Partnership Agreement

If you have any issues completing this form, please reach out to our Sales Team for assistance. 

Company Information

Social Media Outlets

Purchaser/Point of Contact Information

Owner's Information

By submitting this application, I certify that all the information listed on this application is accurate and true to the best of my knowledge. In addition, I acknowledge and understand that the wholesale agreement is strictly offered to customers intended to resell Genie's Therapeutics products and abide by our Internet Minimum Advertised Pricing (IMAP) policy. I understand that Genie's Therapeutics reserves the right to reject this application or terminate it at any time. This application does not grant credit terms. A separate application form is available for this purpose.

Please select the requested products you would like to order below

Once you submit the application, a sales associate will email you an invoice for the requested inventory

Case Count: 6, Wholesale pricing: $270/case ($45 per unit), MSRP: $89.95
Case Count: 8, Wholesale Pricing: $80 ($10 per unit), MSRP: $19.95