REGISTRATION FORM

The information provided in this form will be used only for the purposes of obtaining information on the Applicant. (NB: all fields are mandatory)

CONTACT NAME:

TRADING NAME:
LEGAL REGISTERED NAME:
DATE BUSINESS COMMENCED:

BUSINESS DELIVERY ADDRESS:

PHONE NUMBER:
FAX NUMBER:
MOBILE NUMBER:
EMAIL ADDRESS:
PASSWORD: (for login)

POSTAL ADDRESS: (if different from delivery address)

BUSINESS TYPE:
COMPANY REGISTRATION NUMBER
COMPANY REGISTERED OFFICE ADDRESS

	I / We warrant all particulars provided by me/us are true and correct.
	That under the terms of the Privacy Act 1993 i/we authorize any person or company to provide you with such information as you may require in response to your credit enquires. I/we authorize you to furnish any third party details of this application and any subsequent dealings that I /We may have with you as a result of this application being actioned by you.
	You agree that you will not sell any items purchased from this site on any Daily Deal or Auction Sites.

All prices quoted are exclusive of GST.
All orders are to be paid via Credit Card prior to delivery (enabling you to utilise up to 55 days of credit with your bank).
Any ordered and paid items that are not delivered within 21 days will be refunded back on to your nominated credit card.
Wholesale Solutions reserves the right to vary these terms and conditions of trade and will advise customers of any change in writing.

SUBMIT