Wholesale Application

This is the application form for wholesalers / trade enquiries.

PLEASE NOTE: All fields are required to complete this form.

If you are already a registered wholesaler, please click here

Register Here

Customer Information Company Name *

First Name *

Last Name *

Email *

Website

Phone *

Fax

Physical/Delivery Address Physical Address *

Physical Suburb *

Physical Post Code / Zip Code *

State *

Physical Country *

Billing Address Billing Contact Name *

Billing Address *

Billing Suburb *

Billing Post Code / Zip Code * Billing State*

Billing Country *

Company Information Registered Trading Name *

Years for trading under present ownership *

ABN / License * ABN for Australian businesses

Business Structure *

Owner's / director's details Company Owners / Directors details - Name *

Company Owners / Directors details - Address *

Company Owners / Directors details - Phone *

Credit Reference - 1

Current trade References (financial institution or courier will not be accepted as referees)

Name *

Address *

Phone *

Credit Reference - 2

Current trade References (financial institution or courier will not be accepted as referees)

Name *

Address *

Phone *

Terms and Conditions

I/we consent to the information contained in this application being used for credit reference or credit reporting purposes by JAWA.
I/we agree to pay for all goods ordered through JAWA before goods are dispatched. All delivered goods remain the property of JAWA until full payment is received.
I certify I am authorised to sign this credit application on behalf of the applicant and the above information is true and correct.
Whilst all due care is taken in the delivery of JAWA goods, we are not responsible for any damage after it has left JAWA facilities, or in transit. (It is advised to take the appropriate insurance for your order).
All care has been taken to advise correct and accurate details of all products on this website. However we are not responsible for any inaccuracies and reserve the right to modify the content where an inaccuracy is found.
This handmade furniture and homewares is sold with inherit irregularities that gives each piece its own unique character size and colour. Please not there are often slight variances due to this nature.

I / we agree *

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Jawa Quality Furniture

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Wholesale Application

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