e&s Customer Qualification Form

e&s Customer Qualification Form

Thankyou for your interest in allowing E&S to be a preferred supplier to your business. To assist with our customer qualification process, please fill in our e&s Customer Qualification Form as accurately as possible. This process helps us to understand your business and align you with the right specialist team to provide you with a best-in-class experience. Once reviewed, one our expert team members will be in contact.
How did you hear of e&s?
Has your business previously purchased from e&s?
Type of work Undertaken: (select the option that best fits your business)
e&s Sales Consultant or Key Account Manager:
Please enter name or type N/A if unknown
COMPANY INFORMATION
Company Name:
Trading Name (if different):
Date business commenced:

DayMonthYear
ABN:
ACN:
Do you have a Registered Builders License?
Registered Builders License Number:
Business Address (Street or P.O Box):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Director Name

First NameLast Name
Director Phone Number
Please enter a valid phone number.Format: 0000000000.
Director Email Address
example@example.com
Director Name (no 2) - if applicable

First NameLast Name
Is there a Main Contact who is different to the Director?
Main Contact Name:

First NameLast Name
Main Contact Phone Number:
Please enter a valid phone number.Format: 0000000000.
Main Contact Email Address:
example@example.com
Your Company Website:
www.example.com (lower case required)
Your Company Email Address:
example@example.com
Annual Business Turnover $
Optional
No of Dwellings or Units Constructed Per Annum (approx):
Type of Purchases
Expected Monthly Purchase Value with e&s
Preferred Brands
Please type to enter
Build Locations
If build locations are outside of Melb Metro, Hobart Metro or Canberra, please advise (and list) what towns or cities you build in?
Delivery Location Requirements
Delivery Day Frequency

Other
Do you have any job reference labelling requirements?
Payment Terms Requesting
Accounts Email Address
If requesting a 30-day Credit Trading Account, please provide your accounts email address.
Purchasing
Additional Information
Please type to enter
Should be Empty:

e&s Customer Qualification Form

COMPANY INFORMATION