Seymour Distributing Online Application Form

Seymour Distributing Online Application Form

New Customers please note:

Seymour's is strictly a wholesale supplier.

Your completed application form does not guarantee the opening of an account. The team will review your application and get in touch with you.

Business Name*

Business Owner*

GST Number / ABN*

NZBN / ACN

Postal Address

Delivery Address*

Phone

Mobile Number*

Email*

Business Type*

Select

Nature of Business*

Business Commenced Date*

Business Premises*

Select

Accountant/Bookkeeper Details*

Bank Name & Branch*

Partner/Director 1 Details*

DOB | Phone Number | Postal Address

Partner/Director 2 Details*

DOB | Phone Number | Postal Address

Partner/Director 3 Details

DOB | Phone Number | Postal Address

Partner/Director 4 Details

DOB | Phone Number | Postal Address

Trade Reference 1

Trade Ref 1 Company Name*

Trade Ref 1 Phone*

Trade Ref 1 Email

Trade Reference 2

Trade Ref 2 Company Name*

Trade Ref 2 Phone*

Trade Ref 2 Email

Trade Reference 3

Trade Ref 3 Company Name

Trade Ref 3 Phone

Trade Ref 3 Email

Terms of Trade*

Please read our terms and conditions here.

By ticking the box below, you are confirming that you have read, understood and agree to our terms.

Name of person completing form & agreeing to terms*

If the applicant is a company, then this application form must be completed by a director of the company.

Please upload identification (i.e. passport, licence)*

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse