Wholesale Registration Form

To register an account with us please fill in the details below and you will be contacted once your application has been reviewed. This will take up to 24 hours and an email will be sent to you confirming when your account has been created.

Username

Email Address

Password

Name

First Name

Last Name

Inquiry

How can we help?

If other, please specify

Business Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

ABN

Website

http://

Phone

(###)

###

####

I agree to the Tan Lounge Terms & Conditions of Trade

Wholesale Registration Form

24/7 FOR MEMBERS | 8am - 8pm FOR WALK IN BOOKINGS

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