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Shopping Aisles
My Family Rewards
Support My School
Cleaning Tips
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More
- My Store Locator
- New B2B Customer Registration

Register/Login
Shopping Aisles
My Family Rewards
Support My School
Cleaning Tips
My Account
- My Wallet
More
- My Store Locator
- New B2B Customer Registration

New B2B Customer Registration

- Step 1 of 4

NEW B2B CUSTOMER REGISTRATION FORM (This is not a credit application)

GENERAL (Insert NA in non-applicable fields)

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Holding Company *

Trading Name *

Company Name to Appear of Invoice

Type of Entity *

Private company
Personal Liability Company
Public Company
Non-Profit company
State-Owned Company
Sole Proprietor

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Company Registration No. *

Date Established *

Are you VAT Registered? *

Yes
No

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VAT No. *

Shipping Type *

Delivery
Collection

CONTACT DETAILS

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Title *

Position *

Contact Person Name *

First

Last

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Email *

Cellphone *

Landline

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Postal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your shipping address different to your postal address? *

Yes
No

Shipping Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

TYPE OF BUSINESS

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Select your type-of business *

AGRICULTURE & ENVIRONMENTAL
Automotive
Carwash
Charity & Donations
Church
Cleaning Services
COMMUNITY FOCUSED
EDUCATION
Garage
Healthcare Service
Hospitality
Household Customers
INDUSTRIAL
Internal Use
Old age home
Property Management
Retailer
RETAIL & OFFICE (Including: Clothing Industry, Franchises, Law Firm, Shopping Centres, Malls, Property Management & Body Corporate)
School
Service Provider
State Department/Government
Suppliers
Tender
Transport
TRADE
Wholesaler/Distributor
WHOLESALE
Other

Select your type-of business *

AGRICULTURE & ENVIRONMENTAL
AUTOMOTIVE
COMMUNITY FOCUSED
EDUCATION
HEALTHCARE SERVICES
HOSPITALITY
INDUSTRIAL
RETAIL & OFFICE (Including: Clothing Industry, Franchises, Law Firm, Shopping Centres, Malls, Property Management & Body Corporate)
STATE DEPT./ GOVERNMENT
TRADE
TRANSPORT
WHOLESALE
Other

Other (Please Specify) *

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AGRICULTURE & ENVIRONMENTAL *

AGRICULTURE (Including: Farming & Vegetable Related, Green Houses, Nurseries & Farmers)
ENVIRONMENTAL (Including: Clean-up Services, Refuse or Biomedical Waste Removal, Recycling Plant, Municipal and/or Solid Waste Management, Plant Hire & Toilet Hire)
ANIMAL RELATED (Including: Veterinary Practice, SPCA, Animal Shelters & Dog Parlours)

AUTOMOTIVE *

DEALERS & SHOWROOMS (Including: Car Sales, Car Parts Supplier, Showroom & Car Dealer)
CAR WASH & VALET (Including: Car Wash & Valets)
FUEL STATIONS (Including: Petrol Station, Garage or Forecourts & Filling Stations)
WORKSHOPS & GARAGES (Including: Workshop, Mechanic, Car Services & Repairs, Panel Beater, Tyre Workshop & Garages, Towing Services & Towing Trucks)

TRANSPORT *

AIR TRAVEL (Including: Airlines & Airports)
LAND TRAVEL (Including: Bus Companies, Taxis, Tour Companies, Anyone who works with the passenger related to land travel)
LOGISTICS & FREIGHT (Including: Road & Freight, Long Haulers & Logistics)

COMMUNITY FOCUSED *

RELIGIOUS GROUPS (Including: Churches, Mosques, Temples & Synagogues)
NETWORKING GROUPS (Including: Rotary Clubs, Lions Clubs, Community Centres & Social Clubs)
SPORT FACILITIES (Including: Sport Grounds, Tennis Clubs, Community Sports Centres, Gym, Fitness Facilities & Exercise Groups)

EDUCATION *

PRESCHOOL (Including: All Creches, Day Care & Preschool)
PRIMARY SCHOOL Model C - Part Subsidy (Receive some state funding but also generate their own money from school fees)
PRIMARY SCHOOL Public - State Funded (State funded. They ask little or no school fees and are dependant on the state for funds)
PRIMARY SCHOOL Private - Independent (Independent. Receive no state funding or Government subsidy. Generate their own money)
SECONDARY SCHOOL Model C - Part Subsidy (Receive some state funding but also generate their own money from school fees)
SECONDARY SCHOOL Public - State Funded (State funded. They ask little or no school fees and are dependant on the state for funds)
SECONDARY SCHOOL Private - Independent (Independent. Receive no state funding or Government subsidy. Generate their own money)
TERTIARY (Including: Higher Education, After/Post Matric, Technical, University & College)
OTHER (Including: Special Needs, Art & Drama, Combined Schools, Training & Workshop Facilities & Conference Centre)

HEALTHCARE SERVICES *

Hospitals & Clinics* Private Healthcare (Private general & speciality healthcare departments that are privately owned. Eg. Netcare & Medi Clinic)
Hospitals & Clinics* Public Healthcare (Public general & speciality state healthcare departments that are state owned. Eg. Steve Biko)
MEDICAL & REHAB (Including: Medical Response, Ambulance, Dental, Health & Wellness, GP, Gynea, Optometrist, Physio, Occupational Therapist, Beauty Clinic & Spa)
FUNERAL HOMES (Including: Funeral Services & Homes & Undertakers)
OLD AGE FACILITIES (Including: Old Age Homes, Frail Care, Care Centres & Senior Living & Assisted Living Facilities)

HOSPITALITY *

ACCOMODATION (Including: Camping Grounds, Public Picnic Areas, Nature Reserves, Tented Camping, Guest Houses, Hotels, Hostels & B&B's)
FOOD & BEVERAGE (Including: Catering, Canteen, Bakery, Bar, Restaurant, Coffee Shop & Convenience Food Outlets: Eg. KFC & Nando's)
HOUSEHOLD CUSTOMER (Residential: The housewife that buys for own household residential use)

TRADE *

CLEANING SERVICES (Including: Laundromats, Carpet Cleaning, Window Cleaning, Office or School Cleaning, Pressure Washing Services, Medical & Restaurant Cleaning Services)
MAINTENANCE SERVICES (Including: Home Improvement, Carpenters, Technicians, Roofing Contractors, Landscapers, Painters, Plumbers, Locksmiths & Pest Control)

INDUSTRIAL *

FOOD PROCESS & PRODUCE (Including: Butchery, Abbatoir, Food Processing Plants or Factories, Dairy Facilities & Pre-Prepared Meal Facilities)
MINING (Including: All Manufacturing, Mining, Engineering, Construction Sites & Plant Environments where heavy-duty cleaning is required)

WHOLESALE *

TENDERPRENEUR (For the Tenderpreneur who has a tender and does not consistently supply or resell)
DISTRIBUTOR (For the Distributor, Agent/Hub or Reseller that makes it their business to resell)

Privacy and Communication

We take the Protection of Personal Information seriously and your information will only be used for the purposes provided. Please CLICK HERE to read our privacy policy. By submitting this registration request, you consent to receive educational, company and promotional information from Cleaning Warehouse and accept the Cleaning Warehouse Privacy Policy. With every newsletter communication you will always have the opportunity to update your communication preferences and/or unsubscribe should you no longer want to receive communication from us.

I would like to be added to the Cleaning Warehouse database and receive up-to-date product, cleaning, pricing and marketing-related communication from Cleaning Warehouse.

Yes
No

We take the Protection of Personal Information seriously and your information will only be used for the purpose provided. Please go to our website (www.cleaningwarehouse.co.za) to read our privacy policy. Please select the box below should you want to be added to our database and receive information from us. With every communication you will always have the opportunity to update your communication preferences and/or unsubscribe should you no longer want to receive communication from us.

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Date / Time *

Date

Time

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