Account Application from A J Park

Account Application

Fields marked with * are mandatory.

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print a PDF version of this
account application.

* Name of your A J Park Contact * Account Name Trading Name

* Name of Contact

Mobile Number

* Street Address

Postcode

Postal Address (If Different)

Postcode

* Telephone Fax

Website Email

Business Status

Company

Partnership

Individual

Other

If Other Please State

Company Registration Number

If You Are an Individual or Sole Proprietor Owner's Date of Birth

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authorise A J Park to obtain any information about your credit details within the guidelines set out in The Credit Reporting Privacy Code 2004 issued under section 46 of the Privacy Act 1993
authorise A J Park to pass on any information from this application or its enquiries to other parties only for the purpose of completing this credit application process
confirm you are giving us true and correct information
confirm you have read and agree to A J Park’s ‘Client 'Charter’.