User Email * Confirm Email * User Password * Confirm Password * First Name * Last Name * Phone * ext. Accounts Payable Contact Accounts Payable Phone ext. Accounts Payable Email Company Name * Geographic Region * Anchorage/MatsuFairbanks/InteriorKenaiJuneau/SoutheastRemote/Other Business Type * StorefrontCultivationManufacturingTestingRetailMultiple If Multiple State of Alaska Business License Number * EIN Number * AMCO Number * Submit
