Email Address

*

Password

* at least 5 characters in length

Password Confirmation

*

Full Company Name

*

Trading Name

*

A.B.N.

*

A.C.N. / Business Reg#

*

Date Incorporated

*

Nature of Company Setup

PTY LTD Company Limited Company Partnership Sole Trader *

Legal Structure

Public PTY LTD Trust Company Partnership Sole Trader *

Company Premises

Retail Shop Office Warehouse Other *

Street Address

*

Suburb

*

State

Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia *

Postcode

*

Postal Address Same As Street Address

Postal Address

Suburb

State

Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia

Postcode

Business Phone

Fax Number

Website Address

Principal Systems Sold

Accounting Point Of Sale Portables CAD/CAM Desktop Publishing Networking Home Word-Processing/Spreadsheets/Databases Other *

PC Brands Sold

Notebook Brands Sold

LCD Monitor Brands Sold

Printer Brands Sold

PC's Sold Per Month

Notebook's Sold Per Month

Printer's Sold Per Month

Second Hand's Sold Per Month

Number Of Employees

Directors

Owner Address

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