Form

New Account Form - FOODSERVICE

Please complete this form to set up a wholesale account:

Once completed, you will receive an account activation email
(please check your spam/junk folder if you do not receive the email).
After you activate, you can log in to our website to place orders (www.superkicksmoothies.com).
Orders can either be paid with a credit card at the checkout or placed on account with payment terms.

Only wholesale customers with accounts will be able to order the point-of-sale marketing materials.

First name*

Last name*

Email address*

Email address for placing orders and to receive invoices

Accounts payable email*

Bookkeepers email address or additional email address you would like invoices sent to

Mobile phone number*

Primary contact to receive delivery tracking code

Store phone number*

Secondary contact. Include area code

Business trading name*

Name of shop/cafe for receiving orders. Do not use Company name. Please include "Cafe" or "Restaurant" or "Gym" etc.

Company name

ACN*

Business street address*

Address of shop/cafe for receiving orders. Add Shop # if applicable

Suburb*

Post code*

State*

Country*

Opening time*

Regular opening time to accept deliveries

Closing time*

Regular closing time to accept deliveries

Which distributors are you currently using?

Bidfood, PFD etc.

Delivery Access instructions*

Detailed instructions will help ensure that our drivers can correctly locate your store and deliver the goods.

Any other questions or comments?