ONLINE REGISTRATION AMENDMENT

This FORM is to be used by clients who are currently registered with Canna Farms Ltd, in order to change/UPDATE their existing information on file. A PDF VERSION OF THIS FORM CAN BE FOUND HERE.

New CLIENTS or renewals: PlEASE USE THE FOLLOWING REGISTRATION FORM (online or pdf).

IF YOU HAVE ANY QUESTIONS THEN PLEASE CONTACT US FOR MORE INFORMATION!

APPLICANT INFORMATION
Applicant's Name *
Applicant's Name
Your full legal name is required for us to process your registration.
Applicant's Date of Birth *
Applicant's Date of Birth
Applicant's Physical Address *
Applicant's Physical Address
Please fill in your current legal physical address. Please note that P.O. Boxes are not accepted in this section. If you are SHIPPING to a P.O. Box, then please provide the information in the 'SHIPPING INFORMATION' section below. ADDRESS 1 = Your Street Address (e.g., 1234 High Street); ADDRESS 2 = Apartment/Unit/Buzzer Number (if applicable).
Applicant's Phone Number *
Applicant's Phone Number
SHIPPING INFORMATION
Shipping Address
Shipping Address
Please complete if your shipping address is different than the address provided above. ADDRESS 1 = Your Street Address (e.g., 1234 High Street) or P.O. Box; ADDRESS 2 = Apartment/Unit/Buzzer Number (if applicable)
INDIVIDUAL RESPONSIBLE FOR APPLICANT (IF APPLICABLE)
To be completed by the individual responsible for the applicant. The responsible individual may act on behalf of the registered client. They may make inquiries, changes, and orders on the part of the client
Responsible Individual's Name
Responsible Individual's Name
Responsible Individual's Date of Birth
Responsible Individual's Date of Birth
Responsible Individual's Phone Number
Responsible Individual's Phone Number
AUTHORIZATION