We’re excited to support our wholesale partners as you grow with eekoloks® Haircare Australia. To ensure a smooth and transparent partnership, we kindly ask all resellers to review our Reseller Policy and Terms & Conditions, which detail our order processes, pricing, payment terms, and brand guidelines.

Registered Business Name *

Trading Name *

Business Structure *

Australian Business Number (ABN) *

Australian Company Number (ACN) *

Date Business Registered

Please select your industry *

Website

Address

Street Address *

City *

State *

Country *

Postal Code *

For multiple delivery locations, please upload a file with delivery locations.

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Primary Contact

We need this information to confirm the contact details of the individual completing this form.

First Name *

Last Name *

Phone *

Email *

Additional Payable Person

Account Payable Information

Account Payable Name *

Account Payable Phone *

Account Payable Email *

Purchasing Officer

Purchasing Officer Information

Purchasing Officer Name

Purchasing Officer Phone

Purchasing Officer Email

Business Credit Application

If you wish to apply for 30-day credit terms, please complete the following details and submit the required supporting documents. Once received, our team will review your application and notify you of the outcome, typically within 3-5 business days. Approved accounts will enjoy 30-day payment terms on all future orders.

Director & Partner

Director & Partner Information

Full Name *

Title *

Date of Birth *

Phone *

Email *

Residential Address *

Drivers License ID

Director-Partner Drivers License Photo

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PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Trade Reference

Please provide 3 current trade references.

Trade Reference

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PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Do you want to receive Discounts, Deals & Promotions EDM (Electronic Digital Marketing)

A signature-ready copy of the full contract will be sent to your email immediately upon proceeding.