American Botanicals

Account Creation Request

For American Botanicals to better serve you, let us know about you and your company.

Name

E-mail

Address

City

State

Zip Code

Phone #

Freight Terms
Prepaid
Collect
COD
3 Party Billing

Product(s) Requested

Required Specifications

Heat Sterilization Needed?
Yes
No

QTY in LBS

What form?
Whole
Cut
Chipped
Powdered

Domestic: Minimum Order – 50lbs. or $200.00 per item
Samples - $50.00 each (Covers Cost Only)

Other Remarks or Inquiries:


American Botanicals