Vivian Holdings Detergent Reseller Application
Complete this form to apply to become a Vivian Holdings detergent reseller, and submit your details for pricing and next-step communication.
Welcome to the Vivian Holdings detergent reseller application form. Please complete the details below to apply.
Full Name
*
South African ID Number or Passport Number
*
Cell Phone / WhatsApp Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Province
*
Please Select
Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
North West
Northern Cape
Western Cape
City / Town
*
Physical / Delivery Address
*
Do you have a registered business?
*
Yes - registered company/CIPC
No - I sell as an individual/sole trader
Planning to register soon
Business/Trading Name
Have you sold detergents or similar household products before?
*
Yes
No, this will be my first time
Estimated number of units you'd order per month
*
Please Select
1-10
11-30
31-60
61-100
100+
Preferred way to receive stock
*
Collection from depot
Delivery (courier fees apply)
How did you hear about Vivian Holdings?
Please Select
Facebook
WhatsApp
TikTok
Referral from friend/family
Other
Anything else you'd like us to know?
I agree to be contacted by Vivian Holdings regarding pricing, stock, and reseller terms, and confirm that the information provided is accurate.
*
I agree
Submit Application
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