EmailMe Form - AP-P Provider Application

Verify your state *
30 states & D.C.
Duties:
Providers assist in creating easy access for patients.
Wholesale Provider of medicine, to your own private patients.
The more cannabis users you know, the better the income opportunity.
You do not pay us and we do not pay you. You keep all your earnings.
As a Provider you can take advantage of the group discounts for quantities,
Or get a Membership and increase your earning potential.
Medical Cannabis Certification *

Add File
How many cannabis users do you know in your area? *
1 to 3 others
4 to 6 others
7 to 9 others
10 to 14 others
15 or more others
Why do you think you could be a good provider for your patients?
Your contact information.
How to contact you, if we consider your application.
Email *

Confirm
Name *
First Last
Phone
### - ### - ####
Not required until contracted