Account & Online ordering Application Form

If you have question feel free to call or email us. 020 411 32 713 sales@backtobasic.co.nz

Please note:  We are a wholesaler distributer only.  We do not sell direct to the public. Please view our stockist list here.  

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Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Account Dept.

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Address

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Terms of Trade:

  • Payment 20th month following delivery of goods, without exception
  • Any returns/claims must be made within 48 hours of receipt of goods
  • The goods are sold subject to the condition that the ownership of them does not pass to the Buyer until the goods are paid for in full.
  • We agree to abide by all the above Terms and Conditions.
I agree with the above Terms of Trade. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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All account applications are subject to approval.  We will contact you soon with your account details.  Thank you so much!

Account & Online ordering Application Form

Account & Online ordering Application Form

If you have question feel free to call or email us. 020 411 32 713 sales@backtobasic.co.nz

Please note:  We are a wholesaler distributer only.  We do not sell direct to the public. Please view our stockist list here.  

Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Account Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mobile Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Land Line {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Account Dept.

Account Persons Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Accounts Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Accounts Phone # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address

Delivery Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Postal Address If Different {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

Terms of Trade:

  • Payment 20th month following delivery of goods, without exception
  • Any returns/claims must be made within 48 hours of receipt of goods
  • The goods are sold subject to the condition that the ownership of them does not pass to the Buyer until the goods are paid for in full.
  • We agree to abide by all the above Terms and Conditions.
I agree with the above Terms of Trade. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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All account applications are subject to approval.  We will contact you soon with your account details.  Thank you so much!

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