What's your trading name? ^*

(The name you do business as)

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

What's your legal entity name?

Your registered company/business name (if different from trading name)

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

What's you NZBN? ^*

Find this at companies.govt.nz

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

What type of business are you? ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

What sector applies to you? ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Please share your website

Optional, if applicable

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Who should we contact? ^*

Primary contact person details

First Name ^*

Last Name ^*

Email ^*

Phone Number ^*

Business address ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Additional contact person(s)

Any other relevant contact persons in the organisation? (e.g. accounts, logistics, etc)
Please provide their: Role, Name, Email, Phone number

/

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Delivery address ^*

Where should we send your goods?

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Invoice email ^*

What email address can we use for invoices?

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Trade reference #1 ^*

We'll contact this company to verify your payment history

Company ^*

Contact person ^*

Email ^*

Phone Number ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Trade reference #2 ^*

We'll contact this company to verify your payment history

Company ^*

Contact person ^*

Email ^*

Phone Number ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Your business bank name ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Your bank account name ^*

Must match your account name

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Your account number ^*

For credits only - we won't debit this account

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

📄 Terms of Trade

Please read our Terms of Trade before submitting your application:

Read Terms of Trade

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Your declaration ^*

By ticking this box, I confirm:

✓ All information provided is true and accurate
✓ I've read and agree to the Terms of Trade
✓ I have authority to bind the business named previously in the application
✓ Goods will be acquired for business purposes
✓ I authorize MS Schippers NZ to conduct credit checks

Confirm

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Signature: your full name ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Signature: your position ^*

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Signature ^*

Please draw your signature

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Date (today) ^*

Auto-filled

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Sign electronically

Second director's full name (if applicable)

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Second director's signature

Draw your signature

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Is there anything else that we should know about your organisation?

Feel free to share any details to help us understand better your business needs and how we can help you (optional)

/

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Almost there...

What happens after you submit the application?

1️⃣ Review (2-3 business days)
We'll check your details and contact your references

2️⃣ Approval notification
You'll receive an email with your account details and credit limit

3️⃣ Start ordering!
Log in and select "Pay on Account" at checkout

press Enter ↵

Never submit passwords Report abuse

'Oops! something went wrong.',

Awesome!

Your trade account application has been submitted successfully.

Questions?
Email: [email protected]
Website: msschippers.co.nz

This form was created for FREE using Youform.

Create your own Youform

Youform

Welcome back! Loading your previous answers...

MS Schippers NZ

Apply for a Trade Account
Get flexible payment terms for your business

📄 Terms of Trade

Almost there...

What happens after you submit the application?

Awesome!

Your trade account application has been submitted successfully.

Youform

Welcome back! Loading your previous answers...

MS Schippers NZ

Apply for a Trade AccountGet flexible payment terms for your business

📄 Terms of Trade

Almost there...

What happens after you submit the application?

Awesome!

Your trade account application has been submitted successfully.

Apply for a Trade Account
Get flexible payment terms for your business