Application Process

Start Your Partnership with Lifeline

Complete the Application Form
Fill out the application form below.
Application Review
We’ll review your application and reach out if we need any additional information.
Access to Pricing
Once approved as a wholesale buyer, you’ll gain access to our pricing.

Full Name: Required for identification purposes.
Company Details: Please provide your company name, registration number, and type.
Contact Information: Include a valid email address and phone number for communication.
Address: Your company’s complete postal address.

Important: Please ensure all details are accurate to avoid any processing delays.

New Account

Email Address Required

Password Required

Confirm Password Required

First Name Required

Last Name Required

Company Name

Phone Number

Address Line 1 Required

Address Line 2

Suburb/City Required

Country Required

State/Province Required

Zip/Postcode Required