Customer registration - australia

For more information on Aurora Lites Australia wholesale and to open an account, please complete the below registration form with as much detail as possible. We will review your registration and aim to get back to you within two working days.

Company/Business/Trading Name

Tax Number (ABN)

Which of the following describes your business

can select multiple

Retailer

Wholesales

Distributor

Online Store

Other

History

How Long have you been trading?

Primary Contact

First Name

Last Name

Job Title

Primary Email

Primary Phone Number

Include area code

Finance Contact

If applicable

First Name

Last Name

Finance Email

If applicable

Finance Phone Number

Include area code

Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address

If different to shipping

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Payment Preference

Let us know if you would like to receive a credit application.

Prepayment

Credit Application

General Comments and Information

Let us know more about your application

Customer registration - australia

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