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Trader Application Form

This form is to be completed by all applicants wishing to register at The Pool Team. This is NOT a credit application form.

Customer Information

Registered company name:

Trading as:

Vat Number:

Co. Registration number

Contact Full Name:

ID Number/Passport Number:

Cell Phone Number:

Principal e-mail address:

Postal Address:

Physical Address:

Number of years trading:

Preferred Branch:

Trade references

Company name

Telephone number

Email address

Credit limit

Company name

Telephone number

Email address

Credit limit

Company name

Telephone number

Email address

Credit limit

Company name

Telephone number

Email address

Credit limit

Signed at:

on the

day of the

month of 20

Name of signatory:

Signature:

Clear

On signing of this document, I hereby confirm that:

The above information is true and correct.

I am duly authorised to sign this document on behalf of the company.

The above signatory is the only person that is duly authorised to use the following COD Screen.

* You must complete all fields and sign the form before submitting.
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