/// The Courier Guy /// Worldwide Express

Printable Application form:

If you prefer to fill in a hard copy form, please click here to download and fill in your application form. (PDF 704Kb)

Company Name:

Full Business Trading Name:

Herafter referred to as the Client

Business Details:

First Name/s:	Last name:	ID No.:
First Name/s:	Last name:	ID No.:
VAT No:	Company Registration No:

Contact Person:

First Name/s:

Last name:

Accounting Contact Person:

First Name/s:

Last name:

Designation:

Address Details:

Physical Address (Domicillium citandi et executandi)

Postal Code:

Physical Address (If different from physical address)

Postal Code:

Contact Details:

Primary Phone No:
Fax No:
E-Mail:

Secondary Phone No:
Cell No:
Website:

Do you wish to receive POD's by E-Mail?:

General Shipping Details:

Description of goods generally carried:
Destination usually shipped to:

Banking Details:

Bank Name:
Account no.:

Branch Name:
Branch Code:

Trade References:

1:		Phone no.:
2:		Phone no.:
3:		Phone no.:

Credit Required:

Amount of credit required:

(p/m) Terms of Payment: On Statement / 30 Days

Surety Agreement:

I/We the undersigned understand and accept all aspects of your Standard Trading Conditions as stated on this website by clicking here. I/We furthermore and being the signatory on this agreement do hereby bind myself/ourselves as surety and co-principal debtor/s for all amounts which are now or may in the futrue become due by the Client to the Courier Guy, and waive the benefits of excussion and divisions. I/We hereby choose domicilium citandi et executandi at the address of the company set out under "Address Details" above for all purposes and may amend this by notice in writing to the company.

Finish:

Full Name (Signatory):	Date:	Designation:
We, the above registered company have read and accept The Courier Guy terms and conditions of contract, and hereby confirm that all information filled in the above fields to be true and correct. Please accept the checking of the "Agreed" checkbox below and the submission of this form as our official acceptance of The Courier Guy terms and conditions of contract and the above named signatory's official signature. The signatory warrants that he/she is authorised by the Client to appoint The Courier Guy under these Terms and Conditions.
Agreed (You must check the box in order to continue)