Wholesale Buyer Application

Thanks for your interest in becoming a Glass Cocoon^® stockist. Please complete the application form below.

If you have any questions, please contact us.

"*" indicates required fields

Full name*

Business name*

Website URL*

Your position in the business*

Email address*

Phone number*

Business address*

Postcode*

What retail category would you classify your business as being?*

Gift and/or homeware

Hospitality and/or entertainment

Marine and/or outdoor

Wine

Other beverages

Promotional company

Other category

"Other" category*

How will you sell our products?*

Online

Bricks & mortar only

Both online, and bricks & mortar

Please tell us a bit about your business and customer base.*

PO Box 167,
Silverdale, 0932

+64 21 934 938