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    		 Bombora Coffee & Water Supplies :: Wholesale Registration Form

    REGISTRATION FORM

    If you are a domestic customer looking to buy a water filter then visit our online store at www.fridgefilters.com.au

    If you are a home user looking for where to buy our coffee machine products then send your postcode to sales@bomborasupplies.com.au and the products you are interested in and we will email you your nearest distributor.

    Wholesale enquiries will be contacted within 24 hours of registration - urgent enquiries should call on 1300 724 249 during business hours.





    The fields marked with * are mandatory.

    Wholesale Registration Form
    Personal information
    Title *
    First Name *
    Last Name *
    Business Name *
    A.B.N. *
    Billing Address
    Address *
    Address (line 2)  
    City *
    State *
    Country *
    Post Code *

     

    Address  
    Address (line 2)  
    City  
    State  
    Country  
    Post Code  
    Contact Information
    Phone *
    E-Mail *
    Type of business eg Cafe, Roaster, Service  
    What products are you interested in?  
    Additional information
    Your username and password are controlled by the Bombora Accounts Department. Please contact us on 1300 724 249 or email us with any changes you would like. These will take place with next system synchronisation(usually overnight)
    Username *
    Call Bombora to change Password on 1300 724 249 *
    Password is controlled by back end accounts system *


    Clicking "SUBMIT" you agree with our "Terms & Conditions"
     
    SubmitREGISTRATION FORM


    Information

    Once your application for online access has been approved, you will be issued with a username and a password. Payment by credit cards will be done with pre-registered cards. An application for a trading account can be made upon succesful completion of the account application form.

    Your e-mail address must be valid. We use e-mail for communication purposes (order notifications, etc). Therefore, it is essential to provide a valid e-mail address to be able to use our services correctly.

    All your private data is confidential. We will never sell, exchange or market it in any way.
    For further information on the responsibilities of both parts, you may refer to our
    Terms & Conditions 
     
     
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    Authentication
    Username

    Call Bombora to change Password on 1300 724 249

    Log in 
    Register 
    Recover password

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