Wholesale Application Form

Thank you for your application. Please complete the form below and we will get back to you asap.

Retailer Details

How did you find out about Colour Streams? Magazine Internet Friend Other

Company Name: * Business registration number: * Description of business: * Name of sales manager or contact person: * Website: Number of years in business: * Type of products you currently market: *

Thank you for providing this information. All data will be kept strictly confidential.

Address Details

Mr. Mrs. / Ms.

First Name: * Last Name: * Street Address: * Address Line 2: * City: * State/Province: * Postal/Zip Code: * Country: *

Additional Contact Details

Telephone: Fax Number

Login Details

Email *

Please use your existing Colour Streams account email, or click here to create one then add the email address to this form.

Newsletter and Email Details

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