Page 0 Index
  • Midwest Distribution Vendor Application Form

Page 1 Index

  • New Vendor Application

  • Click "Next" at top of form

Page 2 Index
  • E-liquid Sizes You Wish to Sellselect all that apply

  • Click "Next" at top of form

Page 3 Index

  • Midwest Distribution Requires all Vendors to send in all compliance certification letters for GCC for each bottled e-liquid. (Starting in June 2017 the TPN for each bottled e-liquid will also be required). 

    We also require proof of liability Insurance. 
  • I certify that all my products are compliant with all U.S. Federal and State bottling and saftey regulations. Please check yes to comply.Please check yes to comply.

  • --------------------------------------------------------------------
  • I certify that I have liabilty insurance for my product.Please check yes to comply