Bierfrucht Preferred Buyer Enrollment Form

Section 1: Contact Information

First Name *

Last Name *

Company Name *

Your Position

Phone Number *

Business Email *

Section 2: Business Profile

Industry Type

Choose the option that best represents your business

Years in Business

Business Website (Optional)

Address

Business Location

City

State

Postal code

Section 3: Product Interest and Volume

Estimated Monthly Purée Volume *

How much purée do you expect to order each month? This helps us provide the best discounts.

Primary Purée Needs *

Which types of fruit purées are you most interested in?

Packaging Requirements *

Select your preferred packaging size for purée orders.

Section 4: Program Benefits and Preference

Would you like a dedicated account manager to assist with orders and logistics?

Yes

No

Interested in pre-ordering drums or setting up a regular delivery schedule?

Yes, I’d like to plan ahead

No, I’ll order as needed

Do You Qualify for Tax-Exempt Status?

Yes

No

Businesses in select states where we have warehouses may be eligible for tax-exempt purchases.

Section 5: Additional Information

Are You Interested in Customized Supply Contracts? *

If you need a steady fruit supply, we offer flexible, volume-based contracts

Any Special Requirements?

Your information is secure with us and will not be shared or sold. Bierfrucht will review your application and contact you shortly. Program eligibility is subject to Bierfrucht’s terms and conditions.