Wholesale Application

Would you be interested in becoming a VELAR SHISHA Reseller?

Please complete the form Below.

Business Name

Company Reg No.

Business Address

Postal Code

Business Website (if available)

Business Instagram Account

Email Address

City

Contact Number

WhatsApp Number

First Name

Last Name

Position

ID/Passport Number

Are you based in a Mall/Shopping Complex

Name of Mall

How long have you been in the Hookah Market?

Why do you want to sell VELAR SHISHA Products?

I have read and agree to the Terms & Conditions and Privacy Policy of VELAR SHISHA.

Thank you for your interest in VELAR SHISHA.

Our Agent will be in touch with regards to your application.

Unit 4, 110 Hilton Road, Linbro Park, Sandton, Johannesburg.

Mon-Thurs: 09h00 – 17h00

Fri: 09h00 – 12h00 & 14h00 – 17h00

Sat: 09h00 – 14h00