WHOLESALE

For wholesale enquiries please contact Jacquie or Murray

Email: Jacquie@hillyers.co.nz or murray@hillyers.co.nz | Phone: 348 8909 | Mobile: 0275 332 725

SIGN UP FOR A WHOLESALE ACCOUNT

Please fill out the form below, or download the printable PDF application here.

	Name of Company/Person:*
	Registered Office of Company: (if applicable)
	Postal Address of Company/Person:
	Delivery Address:
	Email Address:*
	Telephone No:
	Facsimile No:
	Credit References:
1. Phone   2. Phone   3. Phone
	I/We confirm that I/we agree to the terms and conditions in this agreement (click to view the terms and conditions) agreement and we authorise Hillyers of Lincoln 2006 Limited to obtain all necessary credit and financial checks for the purposes of assessing and determining the credit account application.
	(click to view the terms and conditions)	Yes
	Name:
	Date::