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Cash Account Form
Referring Business Development Manager (if applicable)
Please Select
Paul Aitchison
Pete Dutton
Referring Trade Counter Member (if applicable)
Please Select
Bec Hughes
Simon Hornsey
Kristine Keates
Toby Brownrigg
Zac Spiero
Section 1: Applicant Details
Organisation Type
*
Company
Sole Trader
Trust
Partnership
Entity Name
*
As it appears on the Australian Business Register (ABN Lookup)
Trading Name (if applicable)
ABN
*
ACN
Industry Classification
*
Carpenter
Commercial Builder
Residential Builder New
Property Maintenance
Residential Builder Additions
Civil and Landscaping
Fitout Contractor
Other
Typical monthly timber spend? (The reason we ask this is it gives us some idea of what quality market you are targeting).
Section 2: Contacts
Full Name - Primary Contact
*
First Name
Last Name
Primary Contact Email
*
Primary Contact Mobile
*
Format: 0000 000 000.
Primary Contact Phone
*
Format: 00 0000 0000.
Account Contact
Same as Primary Contact
Full Name - Account Contact
*
First Name
Last Name
Account Contact Email
*
Account Contact Mobile
*
Format: 0000 000 000.
Account Contact Phone
*
Format: 00 0000 0000.
Section 3: Address Details
Street Address - Postal Address
*
City - Postal Address
*
State - Postal Address
*
Please Select
NSW
VIC
QLD
WA
SA
TAS
NT
ACT
Post Code - Postal Address
*
Physical Address
Same as Postal Address
Street Address - Physical Address
*
City - Physical Address
*
State - Physical Address
*
Please Select
SA
NSW
VIC
QLD
WA
TAS
NT
ACT
Post Code - Physical Address
*
Section 4: Declaration
Please refer to our
Terms & Conditions
Signature
*
Date
*
-
Day
-
Month
Year
Date
Submit Application
Submit Application
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