Bierfrucht Preferred Buyer Enrollment Form

Section 1: Contact Information

First Name *

Last Name *

Company Name *

Your Position

Owner
Purchasing Manager
Head Chef
Head Brewer
Product Developer
Brewmaster
Procurement Specialist
Beverage Director
Executive Chef
Bakery Owner
Supply Chain Manager
Other
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Phone Number *

Business Email *

Section 2: Business Profile

Industry Type

Choose the option that best represents your business

Brewer
Café Owner
Pastry Chef
Food & Beverage Manufacturer
Ice Cream Maker
Kombucha Brewer
CBD Producer
Distributor
Other
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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.

Under 100 lbs
100-500 lbs
500-1000 lbs
Over 1000 lbs
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Primary Purée Needs *

Which types of fruit purées are you most interested in?

Tropical
Berry
Stone Fruit
Citrus
Blends
Other
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Packaging Requirements *

Select your preferred packaging size for purée orders.

11 lb bags (small projects)
44 lb Bags
Drums (bulk use)
Custom Packaging (contact us for options)
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Section 4: Program Benefits and Preference

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

Yes

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

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

Yes, I’d like to discuss this
No, not at this time
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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.