Raceworx

Wholesale account application Strictly confidential

B2B Customer Request

Complete this application to request a wholesale trading account. All fields marked * are required. Submitted information is used for credit assessment and account administration.

1 · Operating provinces *

2 · Company details

3 · Apply for *

Select the payment terms you are applying for. This becomes your account category after approval.

4 · Estimated monthly spend *

5 · Proof of business *

PDF or image preferred. Document should be recent (≤ 3 months where applicable).

6 · Owner / director

7 · Residential / business address

8 · Shipping address

Same as residential / business?

9 · Contact details

10 · Order contact person

Same as owner?

11 · Terms & conditions

I, —, hereby agree to the terms and conditions above.

Draw your signature below (or provide typed signatory name above as fallback). Clear and resign if needed.

Place your order today! Contact your local supplier.

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