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New Account Application

New Account Application - Pearson - Clinical and Talent Assessment

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<strong>New</strong> <strong>Account</strong> <strong>Application</strong><br />

(All details must be completed – Please print clearly)<br />

Trading name:<br />

a division of Pearson Australia Group Pty Ltd ABN 40 004 245 943<br />

and distributing for Pearson <strong>New</strong> Zealand Limited Company Number 85621<br />

Unit No: Street No: Street name: Suburb:<br />

State (Aust. only): Country: Postcode:<br />

Postal/Delivery address if different from above:<br />

Buyer in your organisation:<br />

Phone: Mobile: Fax:<br />

Buyers email address:<br />

<strong>Account</strong>s contact in your organisation:<br />

Phone: Mobile: Fax:<br />

<strong>Account</strong>s email address (your account statement will be emailed to this address unless otherwise advised):<br />

Business Status: <strong>New</strong> Change of Ownership<br />

If change of ownership please answer the following:<br />

Changeover date: dd/mm/yyyy<br />

/ /<br />

Previous trading name:<br />

Previous owner’s forwarding address:<br />

Business Details:<br />

Your business ownership is a: Company Trust Sole Trader Partnership<br />

Registered company name or business name:<br />

Date of incorporation (if applicable):<br />

Other details:<br />

/ /<br />

ACN & ABN (Aus.)/Registration No (NZ):<br />

Director/Proprietor’s full name:<br />

Director/Proprietor’s full name:<br />

Director/Proprietor’s full name:<br />

Private address:<br />

Private address:<br />

Private address:<br />

Private phone:<br />

Private phone:<br />

Private phone:<br />

Date of birth: dd/mm/yyyy<br />

/ /<br />

Date of birth: dd/mm/yyyy<br />

/ /<br />

Date of birth: dd/mm/yyyy<br />

/ /


Description of principal business activity:<br />

Estimated value of monthly purchases through UBD:<br />

$<br />

Trade reference names: Phone:<br />

1.<br />

2.<br />

3.<br />

If a title is unavailable at the time of ordering how do you want the orders treated? (please tick box):<br />

Record orders for all titles including new titles<br />

Record orders for new titles only<br />

Do not record any unavailable titles<br />

For what purpose is your business purchasing product from UBD? ie. for re-sale, for use in a library, for promotional<br />

purposes, etc. If for re-sale, please also indicate the medium(s) through which you will be selling our products.<br />

Have you been in contact with a sales person prior to making this application, if so who? (please circle):<br />

Pearson Penguin Pearson Psychcorp Allen & Unwin Simon & Schuster <strong>New</strong> Holland<br />

Sales Person’s Name:<br />

Acknowledgement and Consent: I/we have received and read the ‘UBD Conditions of Sale’ published at www.unitedbookdistributors.com.au. I/<br />

we agree that the Conditions automatically are part of this <strong>Application</strong> and are incorporated into all purchase orders and all contracts pursuant to this<br />

<strong>Application</strong>.<br />

Reporting to Credit Reference Agencies:<br />

I understand and agree that Pearson may, in the event of difficulty in collecting debts due from me in relation to credit provided following this application,<br />

notify Credit Reference Agencies of any defaults and my conduct in relation to the credit provided.<br />

In making this application, I agree, in accordance with the provisions of the Privacy Amendment Act 1990, that under Section 18 of the Act that certain<br />

items of personal information about me contained in this application is permitted to be kept on a credit information file and may be disclosed to a credit<br />

reporting agency and the information referred to in the Act may occur for the purpose of assessing this application. I acknowledge that this shall continue<br />

to have effect for the duration of any indebtedness to Pearson should this application be approved.<br />

To enable this application to be processed all directors and/or individuals involved in the running/owning of this business must complete all sections of this<br />

application, including Full Name, Current Address and Date of Birth.<br />

Pearson’s Privacy Policy at www.unitedbookdistributors.com.au. I/we agree that Pearson may disclose and use personal information for its own purposes,<br />

including to credit rating agencies, service providers, insurers and any other third parties in connection to any contracts formed pursuant to this<br />

<strong>Application</strong>. Access to personal information on you held by Pearson can be arranged by contacting Pearson’s Privacy Co-Ordinator.<br />

Authorised name and signature of applicant<br />

Name:<br />

Signature:<br />

Completed application is to be emailed to accounts as shown below<br />

Date: dd/mm/yyyy<br />

/ /<br />

Australia<br />

United Book Distributors<br />

a division of Pearson Australia Group Pty Ltd ABN 40 004 245 943<br />

PO Box 701 Hawthorn VIC 3122<br />

Email accounts@pearson.com.au Phone 1800 395 350 Fax +61 3 98112395<br />

Website www.unitedbookdistributors.com.au<br />

<strong>New</strong> Zealand<br />

United Book Distributors<br />

distributing for Pearson <strong>New</strong> Zealand Limited Company Number 85621<br />

PO Box 112256 Penrose 1642 Auckland <strong>New</strong> Zealand<br />

Email accounts@pearsonnz.co.nz Phone 0800 452 523 Fax +64 9 4427400<br />

Website www.unitedbookdistributors.com.au<br />

OFFICE USE ONLY<br />

Discounts Education Penguin NHP Allen & Unwin Simon & Schuster PCTA<br />

Representatives Education Penguin NHP Allen & Unwin Simon & Schuster PCTA<br />

Classifications CC-TOB CC-BG CC-RTLNK<br />

<strong>Account</strong>s Limit Class Terms<br />

12ADMIN17

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