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cultivation facility referral form
Cultivation Facility Referral Form
Retail Store Name
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Retail Store Location
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Retail Employee Name
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Cultivation Facility Name
*
Cultivation Facility Address
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Cultivation Facility Contact Name
*
Cultivation Facility Website/IG/Facebook address(pick one)
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Cultivation Facility Contact Name Email
*
Cultivation Facility Contact Phone Number
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Cultivation Facility Canopy Size (Square Footage)
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(Square Footage)
0-2,000
2,000-10,000
10,000-30,000
30,000+
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