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embassy print solutions

Credit Application Form

   Full Name
   Trading Name
   Addresses:
   Registered Office:
   Address
   City *
   State *    Postcode *
   For Correspondence:(Leave blank if same as above)
   Address
   City
   State    Postcode
 
   Time in business: *
   Type of business: *
   Directors/Proprietors:
 

*

 
   Phone: *    Facsimile: *
   Sales Phone:   Accounts Phone:
   Email: *
   Website:
 
   Trade References:
   1. Name: *
   Phone: *    Contact: *
   2. Name: *
   Phone: *    Contact: *
   3. Name: *
   Phone: *    Contact: *
   Bank Name: *
   Bank Branch: *
* = Required

BY SUBMITTING THIS FORM I/WE AGREE TO COMPLY WITH EMBASSY PRESS PTY LTD ABN 71 006 385 735 TRADING AS EMBASSY PRINT SOLUTIONS PAYMENT TERMS OF 30 DAYS SETTLEMENT