PACIFIC SEA URCHIN AUSTRALIA
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Agent Form
Please fill in the form below for agent registration with Pacific Sea Urchin (AUS) Pty Ltd
*
Indicates required field
First Name
*
Last Name
*
Phone Number
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Company Name
*
Company ABN
*
Are you currently selling sea urchin? If yes, please provide current sea urchin provider/company.
*
If none, please write "None"
Do you do group sale on social media? Please provide the group name in the next question.
*
Yes
No
Do you do group sale on social media, please provide the group name.
*
If none, please write "none"
What type of sea urchin you looking for?
*
Long Spine Purple Sea Urchin
Long Spine Red Sea Urchin
Long Spine Black Sea Urchin
Short Spine White Sea Urchin
Short Spine Black Sea Urchin
Short Spine Yellow Sea Urchin
What grade of sea urchin you looking for?
*
Super Premium 8A Sea Urchin 100g
Super Premium 8A Sea Urchin 50g
Premium 5A Tassie Sea Urchin 100g
Sushi Grade 5A 100g
Sushi Grade Tassie 50g
Mixed A&B Sea Urchin 200g
Mixed A&B Sea Urchin 100g
Boston Trays Tassie Uni 90g
Mixed A&B Sea Urchin 90g
Ensui Sushi Premium 5A 125g
Kina NZ style 100g
Kina NZ style 150g
Your preferred payment method
*
7 Days Credit Term
Direct Deposit
Credit Card
7 days credit term requires additional documents to apply
Why would you like to become our distributor?
*
Submit
Pacific Sea Urchin Home
Products
The Sea Urchin Story
Recipe
Uni Boom Boom
Menu
Contact
FAQ
Agent Form
