Your Name: (required)
Trading Name: (required)
Type of Business eg CC, Pty: (required)
Nature of Business: (required)
Company Registration Number: (required)
VAT Registration Number: (required)
Date Business Established: (required)
Number of Employees: (required)
Cell number: (required)
Telephone number: (required)
Your Email: (required)
Delivery Address: (required)
Postal Address: (required)
Directors/Members (Full Names) - include Copy of ID Book: (required) Attach your copy of ID Book
Bank and Branch: (required)
Bank Account Type: (required)
Bank Account Number: (required)
Person/s Placing Orders: (required)
Estimated Potential purchases/month?: (required)
Trade References 1: (required)
Trade References 2: (required)
Trade References 3: (required)
PLEASE ATTACH THE FOLLOWING DOCUMENTATION ON COMPLETION:
- Company registration documents
- Cancelled cheque or letter from the bank confirming banking details
- VAT certificate
- Scanned copies of the directors/members ID's
Attache your VAT Cerificate (required)
Company Reg. Documents (required)
VAT Certificate (required)
Scanned copies of the directors/members ID' (required)
