New Dealer Registration (FAX)

Fax to:

(011) 618 1934

Attention:

Steven Suntup

Date:


Company Name
Trading Name(if different to above)
VAT number
Company postal address and postcode
Company physical address
Contact person/s
City or town in which located
In what area's do you offer a fitting service?
Do you currently fit solid, engineered or laminate floors?	Solid Engineered Laminate Other
If you fit solid, what installation method do you use?
Do you offer a sanding and sealing service?	Yes No
Are you a member of SAWLFA?	Yes No
How long have you been fitting wooden floors?	in Years (0 for new business line)
Business phone no
Business fax no
Contact cell no
Web address
Contact email address