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Password Application Form
Before you can take advantage of our online ordering and the special offers available through this service you must complete the following information. Once we verify your details you will recieve notification of your password via email.

This feature is only available to EXISTING customers. New customers must first complete either the retail or wholesale application form before a password will be provided.

Please note: Fields marked with an asterisk (*) are required to be completed correctly in order to submit the form.

General Information
* Contact Name :
* E-Mail :
* Business/ Company Name :
 
If you do not have a company name please enter your name instead.

Business Address
* Address (line 1) :
* Address (line 2) :
* City :
State / County / Area :
* Post/Zip Code :
* Country :

Additional Information
* Telephone :
Fax :
Website :
* VAT Reg. Number :

 
You should complete this only if you are a VAT Registered company
based within an EEC country (Excluding the United Kingdom)
US Resale Number :

 
You should complete this only if you are a US-based company
 
* Business Type : Wholesaler    Retailer  
Sales Representative :

 
Please complete this field if you know the name of your Alchemy
sales representative.
   

* Security Code:		 Please type the letters shown here into the box below.
   
 
 

Alchemy Group: www.alchemygroup.com : TEL: +44 (0) 116 282 4824 : Email info@alchemygroup.com
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