Datec Fiji - COD Application Form

VENDOR REGISTRATION FORM
Trading Name:
Legal Name:
Business Registrations Number:
Business Registration Date:
Type of Company:
Specify if "others":
Physical Address:
Postal Address:
Phone Contact:
Company Website:
Company Directors / Partners:	Name \| Phone \| Email ( per line)
Key Office Holders (CEO, CFO, Sales & Marketing Manager, etc):	Name \| Phone \| Email ( per line)
Sales Enquiry:	Name \| Phone \| Email ( per line)
Account Enquiry:	Name \| Phone \| Email ( per line)
Warehouse & Logistic Enquiry:	Name \| Phone \| Email ( per line)
Payment Details
Preferred Payment Method:
BANK DETAILS:
Bank Name:
Bank Address:
Account Name:
Account Number:
Swift Code:
CREDIT TERMS
Credit Days:
Credit Limit:
Attach Business Registration:
I confirm that the information provided it this form is correct and I have the authority to sign this form on behalf of the company.:	Yes

COD Application Form