New Client Details – Brighton Technologies Group

New Client Details

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New Client Details

NEW CLIENT DETAILS

1. Date*
1. Company Name *
Trading As *

1. ABN *
2. Nature of Business *
Please tick appropriate:
1. 1. Sole TraderPublic CompanyProprietary CompanyPartnership
  In support of this application, I/we supply the following information know by the customer to the true and correct
  1. Site Address*
2. 1. Suburb*
  2. State*
  3. Postcode*
3. 1. Site Telephone*
  2. Site Email *
4. 1. Site Contact Name*
  2. Position*
5. 1. Mobile Number
  2. Email
1. Mobile Number
2. Email
1. Group Operation Contact
2. Position
1. Group Operation Address (if different to site address)
1. Suburb
2. State
3. Postcode
1. Delivery Address (if different to site address)
1. Suburb
2. State
3. Postcode
1. Date Business Commenced
2. Period Under Current Management
1. Expected Purchases over 14 days (one period) $
1. Accounts Contact Name
2. Position
1. Accounts Email Address
2. Accounts Telephone

1. Brighton Technologies Group Pty Ltd ABN: 71 068 606 717