New Customer Applications with PocketMail

PocketMail have created a application form to sign up new customers. Using the PocketMail Composer you simply need to fill out the details on the form and submit the customers application form.

Below is an example of what the new customer application form looks like:

	New Customer Application ------------------------------------1. ACCOUNT TYPE 0 Personal/Company or Organisation 0 Student/Lecturer (Go to Sect. 7) 2. CUSTOMER ACCOUNT Registered Business Name: ____________________________________ Trading Name: ____________________________________ Address:____________________________ ____________________________________ Town:_______________________Z\C:____ State/Country:______________________ DX Number:__________________________ DX Location:________________________ Phone:_____________ Fax:____________ Email: ____________________________________ 3. POSTAL ADDRESS (No PO Boxes for Personal Accounts) Attention:__________________________ Dept/School:________________________ Floor:______________________________ Building Name:______________________ Division:___________________________ Address:____________________________ ____________________________________ Town:_______________________Z\C:____ State/Country:______________________ DX Number:__________________________ DX Location:________________________ Phone:_____________ Fax:____________ Email: ____________________________________ 4. CONTACT FOR ACCOUNT ENQUIRIES (Phone No's must be provided) Title:______________________________ First Name:_________________________ Surname:____________________________ Department:_________________________ Direct Phone:_______________________ Direct Fax:_________________________ Email: ____________________________________ 5. CONTACT FOR ORDERS (Phone No's must be provided) Title:______________________________ First Name:_________________________ Surname:____________________________ Department:_________________________ Direct Phone:_______________________ Direct Fax:_________________________ Email*: ____________________________________ (* Legal Express will emailed daily) TRADE/CREDIT REFERENCES A. Name:____________________________ Address:____________________________ ____________________________________ Phone:______________________________ B. Name:____________________________ Address:____________________________ ____________________________________ Phone:______________________________ 7. STUDENT/LECTURER 0 Student Student Registration Number: ____________________________________ Name of Academic Institution: ____________________________________ Course:_____________________________ Length of Course:___________________ 1st Year Enrolled:____ Current Year:____ 0 Lecturer Name of Academic Institution: ____________________________________ Department or School:_______________ Address:____________________________ ____________________________________ Course(s) Taught:___________________ ____________________________________ To be eligible for Lecturer dicounts invoices must be sent to your Institutional Address. 0 Authority to Butterworths (Privacy Act) Form Completed Print contract to fax:____________