Trade Account Application High Street

HSSP Trade Account Application

Reseller or End-User? *
Company Number (NZBN) *
Trading Name of Business *
Type of Business *
Organization Type? *
Full Name of Business *
Phone: *
Website *
Billing Address of Business *

Address

Street Address 2

City State

Country Postcode
Delivery address same as billing Check this box if delivery address is the same as billing address.
- Yes
Delivery Address of Business

Address

Street Address 2

City State

Country Postcode
Promotional Offers Contact
Credit References
1. Credit Reference Name *
1. Credit Reference Phone Number *
2. Credit Reference Name *
2. Credit Reference Phone Number *
3. Credit Reference Name *
3. Credit Reference Phone Number *
Accounts Info
Accounts Contact Name *

First nameLast name
Email for Invoices/Accounts *
Accounts Phone Number *
Purchasing Contact Name *

First nameLast name
Email for Purchasing *
Purchasing Phone Number
Name and Address of Accountant or Registered Office
Bank Name and Branch *
Estimated Annual Spend?
Your Details
Name *

First nameLast name
Email *
Position
Phone
Agree to the Terms and Conditions * By Selecting this box, I hereby declare I have read the Terms and Conditions in the link in footer below and have accepted said terms.
- Agree
Submit