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Trader Application Form

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 Email Address

Postal Address

Physical Address

Number of Years Trading

Branches

Trade references

Hidden Fild

Company name

Telephone number

Email address

hiden3

Credit limit

Company First

Company Name

Telephone Number

Email Address

Credit Limit

Company second

Trade Company Name

Telephone Number 2

Email Address 2

Credit Limit 2

Company third

Trade Company Name 3

Telephone Number 3

Email Address 3

Credit Limit 3

Signature

Signed at

on the

day of the

month of 20

Name of Signatory:

Other Box

Clear

The information above is true and correct

The information above is true and correct.

I am duly authorized 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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