New Retailer Application

First of all, we thank you for your interest in partnering with us.

We love collaborating with businesses who share similar values with us and loves our kombucha! Please fill out your information below and we will get back to you soon!

Contact Person's Name *
Contact Person's Name
Phone *
Preferred Methods of Payment *
The following are the payment method we current are able to accept. Please choose your preferrence.
Billing Address *
Billing Address
Shipping Address
Shipping Address
If different than billing address.
Kombucha Format *
We offer Happy Belly Kombucha in 2 formats. One is served on draught, which is sold in keg format. And the other is in can format. Please choose the format(s) that you are interested in carrying.
Estimated Start Date *
Estimated Start Date
Please let us know when you would like to start carrying Happy Belly Kombucha product.
Please tell us how you learn about Happy Belly Kombucha so we can give credit to where it belongs.
Please let us know any additional information that you might want us to know about your business or any questions you might have for us here.