Delta Industries
This form must be completed in full. Please ensure that all supporting document are submitted with this form. Do not email any documentation.
All fields marked with * are compulsory.
Registered Company Name *
Trading As [Optional]
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Company Physical Address
Address (Line 1) *
Address (Line 2)
Suburb
City/Town *
Province * GautengEastern CapeFree StateKwaZulu-NatalLimpopoMpumalangaNorth-WestNorthern CapeWestern Cape
Postal Code *
Authorised Primary Contact - The person who will sign the contracts.
Full Name *
Email *
Telephone Number *
Administrative Contact - The person who will deal with accounts and operations. [Optional - If different from Primary Contact]
Full Name
Email
Date of Application *
Company Reg. No *
Company VAT No
Please upload the following documents [Those marked * are compulsary] Company Registration Documents *Director's ID *Company VAT Registration LetterDME LICCompany FICA DocumentsBank Letter Confirmation
I hereby give my consent to Delta Industries PTY LTD to collect and my information for the purpose wherefore it's legally required in order to process the application in accordance with POPIA and acknowledge that I have read and understand POPIA.
Click here to read more about POPIA and our consent to information policy.
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