Alexander Essentials UK
     
How did you hear about AE?*
 
First Name*  
Last Name*  
Address Line 1*  
Address Line 2*  
Town  
County  
Post Code*  
Country*  
 
Daytime Phone  
Evening Phone  
Email Address*  
 
Public liability insurer*  
Policy Number*  
 
Would you like more information on:   Buying AE Organic products?
Hosting a coffee morning / evening party?
Starting your own business with AE Organic?
 
What is the best time to reach you?  
 
Have you previously had contact with a distributor?   Yes
No
 
If yes, what was your distributor's name?  
(Please provide as much information as possible on their name or town or where you met them and we will do our best to find the correct distributor.)
 
Any other questions or comments?  
 
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When you have submited your form you may be asked to fax over your public liability form.
 
We may also call you to confirm and verify your details. This enables us to check that you are a trade customer. Once this is approved you will receive your customer number and you then will be directed back to begin shopping. This customer number will also allow you to shop instore.
 
Please Note: All our new accounts are subject to our standard terms & conditions.privacy and data protection.

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