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Customer Group

Retail / Public

WHOLESALE TRADE ACCOUNT

First Name

Last Name

E-Mail

Telephone

Fax

Business type

'Other' Business Type

Company Name

ABN

Business website or social media (please provide a link).

Please tell us about your business and what you are using the rose plants for.

Do you believe you will be ordering over 50 plants?

Additional Information: please note, we may contact you for further documentation that shows you are opperating this business.

Company

Address 1

Address 2

Suburb

Post Code

Country

Region / State

Company Address

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