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Trade Application Form
I ("the customer"), hereby make application to purchase goods from DESIGN11 (PTY) LTD (“the company”) as a TRADE BUYER.
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* Indicates required question
Full Legal Name of Business:
*
Your answer
Trading Name (if different from legal name):
Your answer
Company Registration Number:
*
Your answer
VAT Registration Number (if registered):
Your answer
Name of holding company (if subsidiary company):
Your answer
Website address:
Your answer
Facebook Page link:
Your answer
Instagram link:
Your answer
Delivery Address:
*
Your answer
Postal Address:
*
Your answer
Telephone number:
*
Your answer
Contact person:
*
Your answer
Cellphone number:
*
Your answer
Email address:
*
Your answer
Accounts contact person:
*
Your answer
Accounts Email address:
*
Your answer
What is the nature of your business:
*
Interior Decorator
Retail
Architect
Other
Trade Reference 1
Trade reference name:
*
Your answer
Trade reference address:
*
Your answer
Trade reference phone number:
*
Your answer
Trade reference average monthly purchases:
*
Your answer
Trade Reference 2
Trade reference name:
*
Your answer
Trade reference address:
*
Your answer
Trade reference phone number:
*
Your answer
Trade reference average monthly purchases:
*
Your answer
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