New Customers

Welcome new customers! Please fill out the form below to begin setting up your account in to our system. After completing the form you will be contacted by our admin team to finish the process.

Thank you and we are excited to start serving you!

Company Name

What would you like to purchase from us?

Beer
Wine/Cider
Non-Alcoholic (like Soft Drinks, Juice, Water)

Do you want to pay electronically?

What is the trade name on your permit?

Primary Contact Name

First

Last

Primary Contact Email

Primary Contact Phone

Business Phone

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Is this the same as the Mailing Address?

County

W-9 Form

Drag & Drop Files, Choose Files to Upload

Do you have a NC Tax Exemption form filled out and ready to upload?