Register your company

We are building an exclusive, international network of outlets. Each application is assessed personally. If your company is found suitable as a point of sale, you will get access to our ordering portal.

Sign up

You can register your company using the form below.

Approval

We will assess your application. Upon approval, you will be notified.

Ordering

After creating your account, you can order in our order portal.

become an outlet

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Next Steps: Install the User Registration Add-On

This form requires the Gravity Forms User Registration Add-On. Important: Delete this tip before you publish the form.

Company name*

Chamber of Commerce number*

First name & surname*

Name Surname

Email address*

Phone number*

Address*

Address City Province Postcode Country

CAPTCHA

Phone

This field is for validation purposes and should be left unchanged.