NZ Trade Account Application

Reseller or End-User

Date:

Company Number:

*Trading Name of Business:

*Type of Business:

*Organisation Type

Full Name of Business:

*Phone:

Website:

*Trading Name of Business:

*Billing Address & Post Code:

*Delivery Address & Post Code:

Promotional Offers Contact:

Credit References - Name and contact phone numbers

*1. Credit Reference Name

*1. Credit Reference phone number

*2. Credit Reference name

2. Credit Reference number

*3. Credit Reference name

*3. Credit Reference number

*Email Address for Invoices:

*Name of Accounts Contact:

*Email Address:

*Phone:

*Name of Purchasing Contact

*Email Address:

*Phone:

Name and Address of Accountant or Registered Office:

*Bank, Name and Branch:

*What would be your estimated annual spend with us?

*How did you hear about us?

Have you dealt with anyone at Lynn River? If so, what was their name?

*Terms and Conditions

I agree to the Terms and Conditions

Click here and please read (T&C)

Name:

Position:

Phone:

Office Use Only

CCode

Source/ Ind / Type

AM / Terr

PList / CEGroup

Click here and please read (T&C)

Office Use Only

About Us

Support

Account

Recently added item(s) Cart is Empty

Click here and please read (T&C)

Office Use Only

About Us

Support

Account