Application for Credit Account A. APPLICANT’S DETAILSName or Trading Account:*Delivery Address:*Choose Location:North IslandSouth IslandBird ClubsPostal:(if different for address above)Username:*Email Address:* Password:*Hint: The password should be at least seven characters long. And contain upper and lower case letters, numbers, and use symbols like ! " ? $ % ^ & Enter Password Confirm Password Phone:*Mobile:Fax:GST No.:Legal Status (i.e. Sole Trader, Partnership, Limited Liability Company etc):*By completing the fields below the Directors and Partners of this company give an explicit personal guarantee to pay any monies owing to Topflite NZ Limited for any order(s) made.Partner or Director 1:*Residential Address for Partner or Director 1:*Partner or Director 2:Residential Address for Partner or Director 2:Name of Bank and Branch:*B. CREDIT OR TRADE REFERENCES Please give name of firm, location and telephone numberFirm 1:*Phone:*Firm 2:*Phone:*Firm 3:*Phone:*Recommended by:C. HELPFUL INFORMATION. PLEASE READ. We want to make your life easier, so we will provide you with invoices and consignments via email. That way it’s simple to track your orders. You will also be added to the ‘Where to buy’ list on our website, so more customers can find your store. On top of that you’ll be able to place future orders online with us. receive updates & newsletters by email? D. PRIVACY ACT This information is being collected by Topflite Ltd for the purpose for processing this application and for future credit reference.The information will be held by Topflite Ltd at “Rosedale” 5 D RD Oamaru.Topflite Ltd reserve the right to decline to give credit if information requested is not provided. Pursuant to the Privacy Act 1993 you have the right of access to and correction of your personal information held by Topflite Ltd. I/We hereby authorise Topflite Ltd to disclose details of this application to any listed creditor trade referee, and for such referee to provide Topflite Ltd with such personal information as they may require to process this credit application and to maintain the accuracy of the information held. I/We hereby apply to open a Credit Trading Account and agree to the terms and conditions set out.EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.