Full Name

Company

Phone

Email Address

Are You Licensed Or Permitted To Run A Cannabis Dispensary? ( If Yes Please List Your License/ Permit # Below ). GreenSTOP Only Works With Licensed Dispensaries. Are You Licensed Or Permitted To Run A Cannabis Dispensary? ( If Yes Please List Your License/ Permit # Below ). GreenSTOP Only Works With Licensed Dispensaries. Yes No

State License ID

City License ID

Legal Business Name

Address

What Was Your Total Sales Last Year? ( Approximate )

What Was Your Total Labor Cost Last Year? ( Approximate )

What’s Your Average Transaction Amount? (Approximate)

What Excites You About Our Smart Dispensary Platform?

Number