Retailer Form

Email for non-humans

Trading Name *

Store Manager *

Store Email Address *

Store Phone Number *

Accounts Payable Contact Details

Contact Name *

Email Address *

Phone Number *

Head Office Contact Details

Contact Name *

Email Address *

Phone Number *

Marketing Contact Details

Contact Name *

Email Address *

Phone Number *

Sales Figures Contact Details

Contact Name *

Email Address *

Phone Number *

Store After Hours Contact Details/Emergency Contact Details

First Contact Name *

Position *

Phone Number *

Second Contact Name

Position

Phone Number

Retailer Details

Opening Hours *

Retailer Description *

Shop # *

Facebook Page Link *

Instagram Account Link *

Website Link *

Retailer Image Assets

Upload Logo (300px x 300px) *

File name:

File size:

Retailer Image to feature (300px x 300px) #1 *

File name:

File size:

Retailer Image to feature (300px x 300px) #2 *

File name:

File size:

Retailer Image to feature (300px x 300px) #3 *

File name:

File size:

Retailer Image to feature (300px x 300px) #4 *

File name:

File size:

Submit

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Accounts Payable Contact Details

Head Office Contact Details

Marketing Contact Details

Sales Figures Contact Details

Store After Hours Contact Details/Emergency Contact Details

Retailer Details

Retailer Image Assets

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