Authorised Reseller Application

If you would like to apply to become an authorised reseller of aetha’s product catalogue, please complete the form. Please note, various terms and conditions apply and your request might be rejected.

Please note that you will be required to accept our terms and conditions, which you can find here.

* indicates a required field

1Business Information

2Director Information

3Accounts

4Shipping

5Bank Details

6Declarations

Company Name*
Trading Name
Legal Status*
Company Registration Number

Please put your company registration number here. If you are a sole trader, please leave blank.
VAT Registration Number
Registered Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Main Phone*
Website

Director/Partner Name(s)*
Name Email Office Phone Mobile

Accounts Name*
First Last
Accounts Email*
Is your invoicing address different from your registered office address?*
- Yes
- No
Invoicing Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Name*
First Last
Please include a name of a contact who will receive the deliveries
Shipping Email*

Please include an email address for all shipments and related queries.
Phone*
We require a phone number for deliveries. If possible, please use a mobile number, so we can send shipment updates.
Is your delivery address different from your registered address?*
- Yes
- No
Delivery Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Bank Name

We require your bank details, so we can issue refunds if required. If you do not enter any details here, it can delay any refunds in the future.
Bank Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Bank Account Name

To avoid any potential delays, please type the account name EXACTLY as it appears on your bank account.
Account Number
Sort Code

Please enter your sort code without any hyphens.
Credit Facility
Do you require a credit facility?
- Yes
- No
Please note that a credit account is not guaranteed and is subject to a credit check. By completing this form, you consent to a "soft" credit check to be carried out on your company. The credit amount will be dependent on financial stability and credit rating. You may be required to submit further information.
Credit Amount

Terms & Conditions*
I can confirm that I have read and accept the aetha terms & conditions
Authorised Representative*
I can confirm that I am an authorised representative of the company and am authorised to submit this reseller application on behalf of the company.
Reseller Application*
I confirm that the information I have provided is correct and that by submitting this application, does not guarantee approval.
Director / Employee Name*
First Last
Please put the name of the authorised representative submitting this form here.
Please note, that by completing this form you are enabling us to register you on our system and to officially open an account your first order must exceed £1000 + VAT (no minimum order value on all subsequent orders) and be paid on a pro-forma basis. If you have applied for a credit account, this will be activated after your first order.

Authorised Reseller Application

Credit Facility

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Authorised Reseller Application

Credit Facility

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Let's talk

by phone:

+44 (0)3300 437843

by EMAIL:

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