Become a Member

Store Type*
Store Location*
Applicant Details:
Full Name*

First NameLast Name
Position*
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Upload Driver's Licence (both sides)*

Cancelof
Business Details:
Legal Entity Type

Sole TraderPartnershipPrivate CompanyPublic CompanyTrustOther
Legal Entity Name*
Trust Name
Trustee Name
If Trustee is a company, ACN:
Trading Name*
ABN*
ACN
Date Business Commenced

DayMonthYear
Date
Primary E-mail*
example@example.com
Accounts E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Business/Store Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your delivery address different?

YesNo
Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Details of Sole Trader/Directors/Partners

If more than 3 Directors or Partners required to sign, please contact us at admin@cartridgeworld.com.au for a manual application form.

End Person 3
Estimated Monthly Spend*
Requested Credit Limit*
Limits over $20,000 require a Deed of Guarantee and Indemnity to be completed.

Please provide two supplier trade references:*

	Full Name	Company	Phone Number
1
2

I/We confirm that the information provided is accurate and complete. By signing and submitting this application, I/we acknowledge having read and understood all the linked terms and conditions, which are part of this application and form the basis for entering a binding agreement with Independent Ink Group Pty Ltd trading as Cartridge World (IIG). I/We affirm that I/we have the authority to sign and submit this application and, upon IIG's acceptance, to bind the applicant to the agreement and provide the necessary data on their behalf.
Signature*

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Details of Sole Trader/Directors/Partners