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2 Shornden Passage
St Leonards-on-Sea
East Sussex
TN 37 6SQ

T: 01424 719707
F: 01424 441 561

Affiliate Signup

This module gives an option to enhance the registration process. Impose the verification restrictions for registration process for wholesale customers. May be ideal for capturing additional data during registration like Identification number for professionals, Business number for whole sale customers.

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Your Personal Details

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* Last Name:
* E-Mail:
* Telephone:

Your Business Details

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* Company Registration No.:
* VAT No.:
* Your Company Style: Sole Trader    Partnership    LTD Company

Your Address

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Address 2:
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Alternative Contact

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Trade References

Trade Reference 1
Full Name:
Trade Reference 2
Full Name:

Your Password

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