Blazing the trail together

Business Name

Primary Contact

Business Address

License Type (Check all that apply)

Cultivation Manufacturing Retail Ancillary

Primary Email

Primary Phone Number

Please Upload Your Business Logo (png or jpg)

How do you plan to pay your fee?

Drop Off Mail In

How do you plan to pay your fee?

Drop Off Mail In

When do you plan to submit/mail/drop-off your payment?

Please mail your $300 fee to:

AMIA
PO BOX 190283
Anchorage, AK 99519

Please make your check payable to AMIA

coming soon

Please deliver your $300 fee payment to one of the following locations:

Northrim Bank

Any Location
(reference payment to AMIA checking)

East Rip

Attn: Ryan Tunseth
10767 Kenai Spur Hwy, Space D – Kenai

Enlighten Alaska

Attn: Jane Stinson
2600 Spenard Rd – Anchorage

GOOD Cannabis
Attn: Greg Allison
356 Old Steese Highway – Fairbanks

Top Hat

Attn: Lacy Wilcox

2315 Industrial Blvd – Juneau

(Please text before arrival 907-419-0961)