Account Registration

NY CAURD licensee account registration

"*" indicates required fields

CAURD Company Name (LLC/corp.)*

OCM CAURD License Number*

>OCM-AUCR-22-[ex. 000123]

OCM CAURD License Expiration Date*

Dispensary DBA Name*

Address*

Street Address Address Line 2 City ZIP / Postal Code

OCM Designated Region*

Days of Operation

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Check all that apply.

Opening Hours

Closing Hours

Name*

Email*

Phone*

Delivery Preferences

[e.g., "No deliveries past 6:00 PM"]

Location of Delivery Door

[If you do not accept delivery of orders through the front door, please provide a detailed description of your delivery door's location.]

[Please provide us with the name/number of your intake manager if you require a heads-up.]

Name

Number