User account

Supplier Registration Application Form

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Company Information

Company Name:

Address Line 1:

Address Line 2:

City:

State / Province: *

Postal Code (4 digit): *

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Country: *

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Web Address:

e.g. http://www.QualityQuotes.co.za The content of this field is kept private and will not be shown publicly.

Contact Information

Position:

Managing Director / Sales Manager etc The content of this field is kept private and will not be shown publicly.

First Name:

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Last Name:

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Phone:

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Fax:

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Cell:

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Package Information

Products, Services and Solutions you Provide?: *

Services you would like to receive request for quotes on. (e.g. automotive lifts,spray booths...) Please COPY AND PASTE CURRENTLY LISTED SERVICES from our hope page only, however other requests can be added for new business solutions. The content of this field is kept private and will not be shown publicly.

SMS Notification Service Number:

If you would like an SMS alert sent to you please put the number in above. The content of this field is kept private and will not be shown publicly.

Subscription - Service Range: *

Do you offer your services locally, nationally or international including Angola, Botswana, Mozambique, Namibia, South Africa, Zambia and Zimbabwe. The content of this field is kept private and will not be shown publicly.

Bank Name:

(e.g. First National Bank, ABSA...) The content of this field is kept private and will not be shown publicly.

Branch Code:

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Account Name:

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Account Number:

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Account Type:

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Riaan said that he found using Quality Quotes "excellent"

good responses from the suppliers and very happy with the result all round! (28.12.09) - Ref: 2417

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