Retailer Application

Bring the everyday goodness of Namibia Dairies' portfolio into your retail outlets.

All fields marked with an asterisk (*) are required

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General details

First name *

Enter first name

Last name *

Enter last name

Phone number *

Enter the phone number

Email address *

Enter the email address i.e. example@yourcompany.com

Preferred contact method

Select your preferred contact method

2/3

Physical address

Country *

Select one of the countries

Company registration name *

Enter company registration name

Company trading name

Required, enter company trading name

Application type

Make a selection from the list

Company contact email address

Use Contact Email address

Required, enter the company email address

Company phone number

Use Contact Phone number

Required, enter the company email address

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Business details

Street address *

Enter the street address

Street address line 2

Required, street address

City / Town *

Enter the city / town

Building / Shop / Center

Required, enter the building

Province / Region *

Enter the province / region

Thank you! Your submission has been received! You will be contacted to continue the application process.

Headquarters

15, Gold Street Prosperita,  Windhoek, Namibia

+264 61 299 4700

!Aimab Superfarm

Hardap Irrigation Scheme, Mariental, Namibia

+264 63 242 980

Manufacturing plant

No. 1, Sam Nujoma Drive, Avis, Windhoek, Namibia

+264 61 299 4700

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