Hi-Tech Express Sensitive Freight Transport

Online Management | Request For Account

We wish to open an account with your company for Transport/Storage.
Details are as follows:

Company Name:

Accounts Contact Email:

ABN:

Accounts Contact:

ACTUAL ADDRESS:

Street:

Suburb:

State:

Post Code:

POSTAL ADDRESS:

same as above

Address:

Suburb:

State:

Post Code:

Phone:

Fax No:

Email:

Proprietors or Directors:

Type of Business:

Trade References: (List at least Three)

Contact	Phone	Fax	Email
Contact	Phone	Fax	Email
Contact	Phone	Fax	Email

By Submitting this application we certify that the information given is true and correct and we agree to adhere to the standard payment terms of Hi-Tech Express Holdings Pty. Ltd.

Person submitting form:

Position: