Suppliers - List Your Business

Please enter your details (all fields marked with an * are mandatory):
Supplier Name: *
Contact Name/s: *
Contact Number: * (please don't leave spaces or use brackets)
Alternate contact number: (please don't leave spaces or use brackets)
Email Address: *
Website:

 
Business Address Details: Please note that you can choose to display your full business address, online business only, or just the Suburb,State and Postcode.
 
Display full address?: * Yes No (only Suburb, State and Postcode) Online shop only
Address line 1:
Address line 2:
Suburb/Town:
State:
Postcode:
Business Phone Number:
Opening hours:
More Business locations?: *

Yes No -- Please note that if you select "yes", you will be see a new page to enter more locations after you have completed the details on this page and clicked the submit button.

Postal Address Details: (For online only businesses - must be completed and cannot be a PO Box)
Is postal address same as business address?: * Yes No. If No, please fill in below:

Address line 1:
Address line 2:
Suburb/Town:
State:
Postcode:

Display postal address?: * Yes No

About your Business:
Overview of your business (500 character max): *
Characters Left

Would you like to attach a logo for your business to your listing? * Yes (I will email a file with my logo) No Post (I will send a logo in the mail to be added to my listing)
Notes or comments to eDance Admin (250 character max) (Will NOT be displayed on your listing. For eDance use only)
Characters Left
 
Discount coupon code: (if applicable) (case sensitive)



 
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