To place an online order: Companies and traders must first apply for registration as a bona-fide trade customer. Please note: Applicants will be contacted within one working day on receipt of this application. Successful applicants will be issued with their specified account number.

To apply please complete the following form, when you have completed the form, press the Apply now button. Alternately you can download our Trade application and fax it back to +27 21 424 0008.

SECTION A: GENERAL DETAILS

SELECT AN OPTION:	New Update
REGISTERED COMPANY NAME:
TRADING NAME:
COMPANY REGISTRATION No:
COMPANY VAT No:
PHYSICAL ADDRESS:
POSTAL CODE:
POSTAL ADDRESS:
POSTAL CODE:
LAND LINE No:
FAX No:
MOBILE No:
COMPANY E-MAIL ADDRESS:
NAME OF BUYER:
TEL NR. OF BUYER:
PASSWORD:
CONFIRM PASSWORD:

NB: Registered customers will have access to online ordering. To facilitate this process you will be required to enter a user specific password. Your password must be exactly FIVE characters consisting of only letters and numbers. Please specify your password in the space provided above. Remember to keep a confidential record of this password.

SECTION B: CONTACT PERSON

NAME OF CONTACT PERSON:
ID NUMBER:
JOB TITLE:

SECTION C: OTHER INFORMATION

We would appreciate if you can take the time to fill in the following set of questions, which will provide us with valuable information regarding you / your company. This will enable us to improve our services to you.
TYPE OF BUSINESS:		Close corporation (cc)
		Company (LTD)
		Company (PTY LTD)
		Sole Proprietor
BUSINESS SECTOR:		Retail Shop
		Market Trader
		Direct Sales
		Jeweller
		Other (please specify)
WHERE DID YOUR HEAR   ABOUT WESTJEWEL?		Yellow Pages
		Jewellers Trade Directory
		WestJewel Customer
		SA Jewellery News
		SA Jewellery Biz News
		Web Search
		Westjewel Email
		Jewellers Online Network Letter
		Westjewel Representative
		Newspaper
		Other (please specify)

SECTION D: VERIFICATION

Please enter the code on the left in the box below as verification.

SECTION E: DECLARATION

I hereby certify that the above information is true and apply for trading status with WestJewel.