Once you have submitted this information you will be asked to upload a LOGO for use with your entry. Please have a logo image prepared in .jpg or .png format.
Company / Business Name :
Contacts
Main Contact's Name:
(not for display)
Communications
Telephone:
Fax:
Email: **
Web Address:
Address
Local/Street Address:
Town/City:
County/State/Region:
Zip/Postal Code:
Country:
   
   
Services Offered
Please select from the list below all of the services that you / your company offer.
 
  We have a conventional Walk-in store ?
  We offer a conventional Mail Order service ?
  We have an E-commerce enabled, Online Sales website ?
  We are an Alchemy Gothic dealer ?
  We are an AlchemyPOKER dealer ?
  We are an UL13 Alchemy dealer ?
   
Business Classification
Please select from the list below just one main classification that best describes your business.
Classification headings: Choose one only.
1.  Clothing  2.  Boots & Shoes 
3.  Jewellery & Giftware  4.  T-shirts & Merchandise 
5.  Leather & Accessories  6.  Erotica, Fetish-Wear & Lingerie 
7.  Fangs, Eyes, Nails, Hair & Cosmetics  8.  Halloween, Costumes & Weapons 
9.  Piercing & Tattoo Studios  10.  Magic, Occult, Psychic & Pagan 
11.  Furnishings, Decor & Interior Design  12.  Designers, Artists & Craftsmen 
13.  Food & Drink  14.  Books & Magazines 
15.  CDs, Records, DVD & Video  16.  Software & Computer Related 
17.  Musical Instruments  18.  Publishing & Music Industry Services 
19.  Performers, DJs, Agents & Organisers  20.  Clubs, Pubs, Restaurants & Bars 
21.  Attractions, Exhibitions, Activities & Tours  22.  Hotels & Guesthouses 
23.  Charities & Foundations 
   
Business Description (50 words maximum)

Once you have submitted this information you will be asked to upload a LOGO for use with your entry. Please have a logo image prepared in .jpg format.

 
   
   
Your entry is now ready for submission.