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Questions marked with * are required
Code
Please enter your business name*
Select your business category*
Retail tyre store
Mechanical workshop
Dealership
NZBN number*
Telephone #1
Telephone #2
Telephone #3
Business email address*
Contact ID*
Main contact person - First name*
Surname*
Position*
Mobile*
Verification Code Sent
Email address*
Password you want for online access*
Billing address
Address ID*
Street and number *
State*
Northland
Auckland
Waikato
Bay of Plenty
Gisborne
Hawke's Bay
Taranaki
Manawatū-Whanganui
Wellington
Tasman
Nelson
Marlborough
West Coast
Canterbury
Otago
Southland
City*
Country*
ZIP Code*
Is your shipping address your billing address?
Yes
No
If no then please enter shipping address below
Shipping address
Address ID
Street and number
State
Northland
Auckland
Waikato
Bay of Plenty
Gisborne
Hawke's Bay
Taranaki
Manawatū-Whanganui
Wellington
Tasman
Nelson
Marlborough
West Coast
Canterbury
Otago
Southland
City
Country
ZIP Code
Do you belong to a franchise group (eg Tyrepower, GoodYear, Autocare), if so which one?
Security Code
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SUBMIT FORM
Payment terms
Credit limit
Payment method
Pricelist
Commitment limit*
Shipment type
Truck run 02
Brand ex
Truck run 01
Truck run 03
Brand ex
