top of page
IMG_0893 copy.jpg

Maria's Coffee Retailer Application & Agreement

Please complete the below in full.

NOTE: Maria's Coffee reserves the right to either accept or reject your appointment without disclosing the reason thereof.

APPLICANT DETAILS

Company
Closed Corporation
Private Individual
Co-Operation
Partnership
Retailer Type
Hotel
Guesthouse
Restaurant
Coffee Shop / Deli
Retail / Grocery
Gift Store

PROPRIETOR / OWNER DETAILS

SIGNATORY

The Signatory warrants and guarantees that:


(a) he/she has full right, title, authority and capacity to act for and on behalf of the Retailer herein;


(b) he/she has full right, title, authority and capacity to bind and subject the Retailer to any and all of the terms and conditions contained in any and all of the sections of this Agreement;


(c) he/she has read all the sections of this Agreement and understands each and every provision contained in such sections; and


(d) all information furnished in any and all sections of this Agreement, with regard to the Retailer or himself/herself, is true, accurate and correct.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
bottom of page