Tel:: 0845 094 2637   International: + 44 (0) 1484 850088  

Home
Key features
Where to buy
GLEE
Contact Us
Search: Advanced search
 
aqua moda :: Profile details

  Categories

  Your cart

  Log in

  News
No news available at the moment

Your email:
Subscribe 

  Help

We accept American Express, Visa, Master Card and Diners.

Dealer application form

If you are interested in purchasing a single water feature then please call us so that we can advise you of your nearest stockist.

Dealer application form

If you are interested in retailing our high quality water features, please fill out the form below, and open the attached PDF documents. Please complete the documents and post or fax back to us on 0845 094 2377.

- aqua moda account opening form

Once we have processed your request we will send you an email to verify that your application has been accepted. You will then be able to log into our website to view product details, descriptions, photographs and specifications for all our products. You will also see the product prices and have the flexibility of ordering products via our website.

Membership categories explained:
- Membership category "Wholesale A" is for customers wishing to hold stock of our products. (Large trade discount is available)

The fields marked with * are mandatory.


  Profile details
Personal information
Title *
First Name *
Last Name *
Company *
VAT number  
Billing Address
Title *
First Name *
Last Name *
Address *
Address (line 2)  
City *
County *
Country *
Postal code *

 


Title *
First Name *
Last Name *
Address *
Address (line 2)  
City *
County *
Country *
Postal code *
Contact Information
Phone *
E-Mail *
Fax  
Web site  
Additional information
Please tick to confirm that you accept our terms and conditions of sale *
Username & Password
Username *
Password *
Confirm Password *
Newsletter
If you wish to receive our Newsletter, please select the News lists to which you want to subscribe:
 
Aqua Moda News
  Aqua Moda News
Image verification
Type the characters you see in the picture. (If you do not see any picture here, please enable images in your web browser options and refresh this page)

Get a different code


Clicking "SUBMIT" you agree with our "Terms & Conditions"
 
SubmitDealer application form


Information

We recommend that your password should be at least 5 characters long and should be different from your username.

Your e-mail address must be valid. We use e-mail for communication purposes (order notifications, etc). Therefore, it is essential to provide a valid e-mail address to be able to use our services correctly.

All your private data is confidential. We will never sell, exchange or market it in any way.
For further information on the responsibilities of both parts, you may refer to our
Terms & Conditions 
 
aqua moda - Unit K1 - Meltham Mills Industrial Estate - Meltham - Holmfirth - HD9 4DS
Tel: 0845 094 2637 - Fax: 0845 094 2377
Copyright © 2007-2009 aqua moda