Application to Advertise on SAA Marketplace
Total Page：16
File Type：pdf, Size：1020Kb
Application to Advertise on Form: P-001 SAA Marketplace Version: 1.0 Date: 5-6-14 Page 1 of 1
1. Certificate Holders Details (Details will appear on the Marketplace website) Company name: Company
address: Company
Website:
Contact Email:
Contact Name:
2. Consultant Details
Business name:
Postal address:
Contact Email:
Contact Name:
3. Product Details (Details will appear on the Marketplace website) Product
description: Main model
number/name: Electrical rating: If you wish to include a photo on the website, please supply with your application form.
4.Declaration by Applicant
Please include my product on the SAA Marketplace and agree to abide by the SAA Marketplace Terms and Conditions.
Authorised
Signature:
Name of
Signatory: Title of
Signatory: Date:
5. Payment Details *PLEASE NOTE: Payments made by Amex will incur an additional charge (Refer to the Schedule of Fees) Verification Code: Credit *Amex Visa MasterCard (Last 3 digits on rear of card or 4 digits on front of AMEX) Account Expiry Date: Number: Card Holders Name: (as shown on card) Signature of Amount to debit cardholder: credit card: $ Please refer to our Schedule of Fees document on our website for EFT details. EFT For Reference: Use 1st 4 letters of applicant name and the Approval Number Payment by EFT will incur an additional AUD20 fee. Please forward a remittance advice Email Application to: [email protected]