Business Name* Contact Name* Email* Phone Website Instagram Handle Resale/EIN # Store Type* Select… Grocery / Market Specialty / Gourmet Café / Coffee Gift / Boutique Liquor / Beverage Other Street Address City State / Province ZIP / Postal Have you ever tried Moore Crunch?*

Yes No

Favorite Flavors (check all that apply)

Buffalo Garlic Ranch Sour Cream & Onion Maryland Crab Cinnamon Sugar Lamb (Limited) Other favorite(s)

Would you like to be added to our Store Locator once approved?*

Yes No

How did you hear about Moore Crunch? Anything else we should know? I’m applying for a wholesale account and agree to be contacted about pricing and terms.