Credit Application

If you wish to open a credit account, please enter your details on the form below. Please attach a copy of your company headed paper if available.

Name
Address
Registration Number
Registered Office
Telephone
Fax
E-Mail
Delivery Address
Accounts payable contact name
Credit limit requested
Name & address of Parent Company
Other relevant information
References
(1) Name & address
Tel. No
(2) Name & address
Tel. No
Business bank
Please state the names of persons who are authorised to place orders on your behalf:
Attach a copy of your letter headed paper (if available)
In applying for credit facilities, we agree to the terms offered by Advatech Ltd being:
Thirty days from the end of the month in which delivery was made.
Please tick the box on the right to confirm you agree.
Form Filled Out By
Position held
Date:
Note: Please allow up to 10 days for references to be checked

Please note: Only press the Submit button once.
If you have attached a file, there may be a delay as the file is uploaded.