Distributor Signup

If you would like to become a ReleaseSCE Distributor, please create an account and further provide copies of both contracts signed; 
 

- If you are a VAT Registered Business or have a Medical Practice Number, please select the appropriate options from the Business Type field and complete the required details.
 

- If you are neither of the above and would like to still become a Distributor, please complete the form below and select Other from the Business Type Field. You will be required to upload a Motivation Letter for consideration.