Open an account with NZ Print

Please complete the following application form in full.
Someone from NZ Print will be in contact to confirm your application.

YOUR CONTACT DETAILS:

First name: *

Surname: *

Phone: *

Mobile: *

Fax:

Email address: *

Approx spend per month: *

COMPANY DETAILS:

Registered Name of Company: *

Trading Name of Company: *

Nature of Business: *

Street Address (Physical): *

City (Physical): *

Postcode (Physical): *

Street Address (Postal): *

City (Postal): *

Postcode (Postal): *

Company Accountant: *

Accountant Phone: *

TRADE REFERENCES Please provide details for three references below:

Reference 1:

Name (Ref 1): *

Address (Ref 1): *

Phone (Ref 1): *

Reference 2:

Name (Ref 2): *

Address (Ref 2): *

Phone (Ref 2): *

Reference 3:

Name (Ref 3): *

Address (Ref 3): *

Phone (Ref 3): *

PERSONAL DETAILS (If Sole Trader/Partnership):

Surname (app 1): *

First Names (app 1): *

Private Address (app 1): *

Phone Number (app 1): *

Date of Birth (app 1): *

Applicant 2 - If Partnership:

Surname (app 2): *

First Names (app 1): *

Private Address (app 2): *

Phone Number (app 2): *

Date of Birth (app 2): *

PAYMENT DETAILS AND AGREEMENT:

Our preference is for invoices to be paid by direct credit: We will send you account details when your application is approved:

Please advise how you will be paying: *



I have read and agree to the terms and conditions of account: *

Date of agreement: *
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