Join Our Family

Wholesale Form 
Business Name
Tax ID Number
Street Address
Retail ID Number
Years in Buisness
  Zip Code
Phone Number
Email Address
# of Seats
 (Restaurants, Bars & Coffee Shops Only)
Business Owners
Decision Maker
Do you plan on selling retail coffee beans to customers? 
What types of coffee are you currently serving/selling?
 Press Pot
 Drip Brewed
 Espresso (Decaf)
 French Press
 Pour Over
Current coffee supplier: 
How long have you used them: 
Reasons for searching out another coffee supplier:
 Delivery Problems
 Lack of Training
Does your current supplier provide equipment? 
If yes, what equipment do they provide?
 Coffee Brewers
 Bean Grinders
 Espresso Machines
 Hot Water Towers

At Dark Matter, we value your privacy. None of the information collected will be shared with others or used for any purpose other than to supply you with Dark Matter Coffee.

Dark Matter Family