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Wholesale Request Form
My Dilly Bag
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Email
*
Your email
First Name
*
Your answer
Surname
*
Your answer
Company Name
*
Your answer
Company ABN
*
Your answer
Mobile Number
*
Your answer
Postal Address
*
Your answer
Delivery Address
*
Your answer
Delivery Instructions
Your answer
How often to you expect to order from us?
Weekly
Monthly
Quarterly
Annually
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Trading Reference # 1- Companies you have dealt with for a minimum of 1 year
Please include the following:
- Name of Contact
- Company
- Phone/Email
*
Your answer
Trading Reference # 2- Companies you have dealt with for a minimum of 1 year
Please include the following:
- Name of Contact
- Company
- Phone/Email
*
Your answer
Would you like to be added to our mailing list
Yes
No
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Special Orders
For extra large orders or special requirements, contact us directly ahead of time so we can fulfil your order. We work months in advance to manage stock levels so please contact us as soon as possible.
A copy of your responses will be emailed to the address you provided.
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