Application for credit account

Branch

Your Suburb / Town / City Your nearest branch is

Applicant’s Details

Full Legal Name Trading Name Company / Applicant Email Address

Physical Address

Physical Address Postcode Phone Number Fax Number

Postal Address

Postal Address the same as above

Postal Address Postcode Phone Number Fax Number

Company Details

Nature of Business Estimated monthly spend Do you currently use a courier company? If Yes, please state the name of the company Would you prefer to receive invoices via post? Please provide email address for email invoice

Credit References

Please supply three (Not including banks, power, phone companies and no personal references)

Reference 1

Company Name Phone Number

Reference 2

Company Name Phone Number

Reference 3

Company Name Phone Number Your organisation type Describe organisation type (if other) Year your organisation started Is the organisation registered? Your organisation registration number

1. Decision Maker

(Authorising the opening of Account)

Title Position First Name Surname Email Address Phone Number

2. User

(Contact relating to User of courier services)

Contact details the same as above

Title Position First Name Surname Email Address Phone Number

3. Accounts

(Contact for accounts payable)

Contact details the same as above

Title Position First Name Surname Email Address Phone Number

Contact with New Zealand Couriers resulted from: Approached by New Zealand Couriers

Yellow/White Pages

Internet search

Courier already delivers to this address

Have used New Zealand Couriers previously

Other

Describe where contact resulted from (if other)

Important: Please note that New Zealand Couriers Limited payment terms are the 20th of the month following the date of invoice/ statement.

The company reserves the right to withhold its services from any customer whose account is overdue until such time as the account is paid.

All consignments are carried subject to the Conditions of Carriage prevailing.

Consent of Disclosure

I acknowledge that I have read and agreed to the terms of the contract and have accepted and agreed to the Conditions of Carriage and Consent of Disclosure. I state I am authorised to agree to these conditions on behalf of the organisation named.

Name Position Email Address Confirm Email Address Date

A confirmation email will be sent to you with all of the details you have completed and a link to our terms of trading and our conditions of carriage.

An account gives you full access to the benefits and peace of mind of our services.

Branch

Applicant’s Details

Physical Address

Postal Address

Company Details

Credit References

Reference 1

Reference 2

Reference 3

Contact Details

1. Decision Maker

2. User

3. Accounts

Consent of Disclosure

Services

Tools

Resources

Follow us

Company