URBAN FLOWER
Tel : +61 2 9745 1668
Email : sales@urbanflower.com.au
Web : http://www.urbanflower.com.au

We are very pleased to offer a 30 days trade account facility, allowing you the flexibility of being invoiced for goods and paying on invoice at the end of each month.

You can order over the phone, by fax, or by email.

Client/Account Information

Contact Person*

Business Name*

Business Nature*

Your ABN*

Street Address*

Address Two (Optional)

City*

Postcode*

Email*

Phone*

Fax

Billing Address

Contact Person*

Street Address*

Address Two (Optional)

City*

Postcode*

Trade References (excluding Credit Cards, Fuel Supplier, Landlord, Power & Phone)

Company Name*

Phone*

Contact Name*

Company Name

Phone

Contact Name

Company Name

Phone

Contact Name

I certify that the above information is true and correct and that I am authorised to make this application for credit. In accordance with the Privacy Act (1988) I authorise any person or company to give information as may be required in response to credit Inquiries.

Print Name

Full Name*

Position*

Additional Information

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Urban Flower Credit Account Application

Please download our Application Form