Application for credit account

An account gives you full access to the benefits and peace of mind of our services. Apply online using the form below or print and send us the PDF version by either mail, courier or fax. Find the details for your nearest branch. For more information call our Customer Services Team on 0800 800 841.

• Account Application Form - PDF Download

* Required field

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Branch
Your Suburb/Town/City:*
Your nearest branch is:*
Applicant's Details
Full Legal Name:*
Trading Name: (If different from above)
Company / Applicant Email:* (Your email)

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Physical Address
Physical Address:*
Postcode:
Telephone:*
Fax:
Postal Address
	Postal Address the same as above
Postal Address:*
Postcode:
Telephone:*
Fax

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Company Details
Nature of Business:
Estimated monthly spend:*
Do you currently use a courier company?	Yes No
If Yes, please state the name of the company:
Would you prefer to receive invoices via post?	Yes No
Please provide email address for email invoice:
Credit References
Credit References - please supply three: (Not including banks, power, phone companies and no personal references)
Reference 1: Company Name:* Telephone:* Reference 2: Company Name:* Telephone:* Reference 3: Company Name:* Telephone:*
Your organisation type:*	Company Partnership Sole Trader  Other:
Year your organisation started:
Is the organisation registered?*	Yes No
Your organisation registration number:

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Contact Details
1. Decision Maker (Authorising the opening of Account) Title:* Position:* First Name:* Surname:* Email:* Telephone:*
2. User (Contact relating to User of courier services) Contact details the same as above Title:* Position:* First Name:* Surname:* Email:* Telephone:*
3. Accounts (Contact for accounts payable) Contact details the same as above Title:* Position:* First Name:* Surname:* Email:* Telephone:*
Contact with New Zealand Couriers resulted from:	Approached by New Zealand Couriers Yellow/White Pages Internet search Courier already delivers to this address Have used New Zealand Couriers previously  Other
Important: Please note that New Zealand Couriers Limited payment terms are the 20th of the month following the date of invoice/ statement. The company reserves the right to withhold its services from any customer whose account is overdue until such time as the account is paid. All consignments are carried subject to the Conditions of Carriage prevailing.

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Consent of Disclosure

I acknowledge that I have read and agreed to the terms of the contract and have accepted and agreed to the Conditions of Carriage and Consent of Disclosure. I state I am authorised to agree to these conditions on behalf of the organisation named. Name:* Position:* Email:* Confirm email:* Date:*

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A confirmation email will be sent to you with all of the details you have completed and a link to our terms of trading and our conditions of carriage.