Application - Retail Opportunity

Registered Shop/Business Name:

Form of business:
Retail Store(s)Internet SalesOther

If other, please specify:

Do you have a website, if yes, please provide details:

Please provide brands of other SNUS products you stock:

Are you looking at selling this brands on your website:

Have you sold any of these brands before:

If so, which:

Please provide business / store's physical location / delivery address:

Business / Store contact number:

VAT Number:

Company Registration No:

Buyers Details

Accounts Person Details

• Approval criteria can be changed without notice.
• By ticking confirm below, you hereby confirm the above information within this 'Retail Application' is accurate and allow to be submitted for the review and approval.

Name: 

Date:

Confirmation: