To apply for a trading account with Urgent Couriers please complete this form, print, then sign and fax to Urgent Couriers +64 9 307 3599 or alternatively scan and email to

New Account Details

Account Name:
Registered Company Name:

Tick to confirm this is your Registered Company Name
Trading As: Sole Trader     Partnership     Limited Company    

Physical Address


Postal Address (if different from Physical address)

Street Number:
Street Name:

Contact Details


Contact People

Main Contact Name: After Hours Contact:
Telephone: Telephone:
Facsimile: Facsimile:
Email: Email:
Mobile: Mobile:
Accounts Contact:

Name(s) & Address of Director(s)/ Partner(s)/ Proprietor(s)

Name 1: Address:
Name 2: Address:
Name 3: Address:

Credit References (please note: Urgent Couriers does not accept Power, Phone or Financial Institutions as referees as they do not provide credit references. For example, do not give: Telecom, Vodafone, Banks, Empower, AGC etc)

Company 1: Phone:
Company 2: Phone:
Company 3: Phone:

Terms & Conditions of Trading

  1. All accounts must be paid for in full on or before the 20th of the month following invoice. Accounts paid under these terms receive a prompt payment discount.
  2. Urgent Couriers Limited reserves the right to withhold services to customers with overdue accounts.
  3. I/We shall pay or reimburse Urgent Couriers Limited all costs and or expenses incurred by it in instructing a Solicitor and or debt collecting agency to recover any amount overdue for payment.
  4. I/We agree with Urgent Couriers Limited's terms and conditions of carriage.
  5. I Give Urgent Couriers Limited the right to check with the entities listed as credit references for any information relevant to my application.
  6. I warrant that the information given above is true and correct and hereby irrevocably authorise Urgent Couriers Limited to obtain information from any source in support of my application. I also acknowledge that information relating to my account/credit status may be used in completing a report for any other party requesting the same.
I/We hereby acknowledge and agree to the terms & conditions above, and also acknowledge that I/We have read and agree to the terms and conditions as set out in pdf form on item 4 above.

Please print this form out by clicking the button below and then sign and fax to +64 9 307 3599