PCO Cash Customer Registration
Are you a registered PCO or reseller of PCO/Hygiene products? Then complete this form to take advantage of our PCO pricing.
Your details are safe with us as we will only use them for internal use.
If you have any questions, please email
info@pesafrica.net
.
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* Required
Your Details
Trading Name (this is the company name for the Tax Invoice)
*
Your answer
Full Names of Applicant (your name, please)
*
Your answer
Company Registration Number
*
Your answer
VAT Registration Number
*
Your answer
P-Number from Dept of Agriculture
*
Your answer
P-Number Expiry Date
*
MM
/
DD
/
YYYY
Delivery Address
*
Your answer
Mobile Number
*
Your answer
Email Address
*
Your answer
Which region do you operate in?
*
Central and Southern Gauteng (Joburg)
Northern Gauteng & Pretoria
Western Cape
Eastern Cape
Kwa-Zulu Natal
Free State
Northern Cape Province
Mpumalanga
North West Province
Limpopo
Other:
Required
Keep us updated with your latest specials and promotions.
*
YES PLEASE!
Not right now, thanks!
Thank you!
We'll send you a Customer Number once you've been added to our system. Please remember to use this for your next order.
T&C's
This is not a credit application, so payment before collection or delivery of your order will still be required.
Submitting this form authorises Pathogen & Environmental Solutions (Pty) Ltd to add you to their customer database.
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