Credit Application

Credit Application Form

Credit Information

Current Credit Terms *

Required Credit Terms *
Other Terms Required

Credit Limit Required *

Please enter the Required Credit Limit

Name of Owner/Principal/Partner *

Phone

Mobile Phone *

Email Address

Trade Reference 1

Organisation or Business Name *

Address *
Please enter the Address

Phone *

Please enter the Phone Number

Email Address *
Please enter the Email Address

Type of account held with this Referee *
(e.g. 14 day credit)

Please enter the Type of Account held

Credit Limit *

Please enter the Credit Limit

Length of time you have held this account *

Trade Reference 2

Organisation or Business Name *

Address *
Please enter the Address

Phone *

Please enter the Phone Number

Email Address *
Please enter the Email Address

Type of account held with this Referee *
(e.g. 14 day credit)

Please enter the Type of Account held

Credit Limit *

Please enter the Credit Limit

Length of time you have held this account *

Trade Reference 3

Organisation or Business Name *

Address *
Please enter the Address

Phone *

Please enter the Phone Number

Email Address *
Please enter the Email Address

Type of account held with this Referee *
(e.g. 14 day credit)

Please enter the Type of Account held

Credit Limit *

Please enter the Credit Limit

Length of time you have held this account *

Preferred Payment Method
Direct Deposit Visa/Mastercard American Express
Note: 1.5% Surcharge applies Note: 3% Surcharge applies

We collect your personal information so we can assess your application for a Wholesale Horticultural Group P/L Credit Account. We will be unable to assess your application or provide you with access to a Business Credit Account without all or part of the personal and other information we require. In order to assess your application for credit you hereby consent to your personal information being disclosed to third parties. This may include disclosure to credit reporting agencies (e.g. Equifax), companies who provide commercial credit references, people you authorise us to contact in connection with this application or any approved Business Credit Account, mercantile agencies and other companies who provide outsourced services to us. Subject to certain exceptions allowed by law you may request access to your personal information while it is stored by us. We will give you reasons where we deny access. We will not share your information with any Marketing or unmentioned third parties. We may use your personal information to tell you about our promotions, products or services we think may be of benefit to you. Agreement *
I have read, understand and agree to the Condition of this Application Form and WHG Terms of Trade
Yes

True and Correct Information *
I declare that the information provided by me in this application is true and correct
Yes

Name *

Please enter your name

Title * eg. Director, Partner, etc.

Please enter your title

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