Type of Entity:
Registered Name of Applicant:
Trading Name of Applicant:
ACN: ABN:
Registered Address:
 
State:
Postcode:
Country:
Email Address:
Phone: Fax:
 
School Delivery Address:
 
State: Postcode:
Country:
 
School Contacts  
Principal's Name:
Email Address:
Phone: Fax:
 
Sales Contact  
Name:
Email Address:
Sales Direct Line: Fax:
 
Accounts Contact  
Name:
Email Address:
Accounts Direct Line: Fax:
 
Bank (Name & Address):
Comments:
 
  Business References
1. Name: Phone:
  Address: Fax:
2. Name: Phone:
  Address: Fax:
3. Name: Phone:
  Address: Fax:
 
Declaration
The Applicant requests PSW Pty Ltd to open an account on the basis of PSW Pty Ltd standard terms and conditions of trading and agrees to be bound by such terms and conditions. The Applicant and the signatory to this Application further acknowledge that the information provided in this Application is true and correct and has been relied upon by PSW to determine whether to grant the Applicant credit and the signatory has full authority to complete this Application Form on behalf of the Applicant.

The Applicant further agrees that PSW Pty Ltd may disclose the information contained in this Application and any default in PSW Pty Ltd's payment terms to a credit reporting agency in accordance with the provisions of the Privacy Act and they obtain a report regarding the Applicant's credit worthiness and credit history from a credit reporting agency or any credit provider named in the Application or disclosed by a credit reporting agency.

I have read the declaration and agree to the terms and conditions