McCoy's Glass Application

Full Name*

E-mail*

Have you been in contact with McCoy's Glass prior to completing this form?*

If yes was answered above, please advise us whom you dealt with?

Office Number

Cell Number*

Company Name if Registered

Company Registration Number

VAT Registration Number

Members/Director/Partners/Owners Identity Numbers*

Physical Address (Please include Postal Code)

Postal Address (Please include Postal Code)

Documents Required with Form:

CK Document

Vat Registration

Identity Document / Individual*

Identity Document / Individual (2nd person)

Identity Document / Individual (3rd person)

Is you offloading area Level?

Yes
No

Please provide us with a few pictures of your offloading bay/area?*

Glass Requirements (QTY, Product and Size)*

McCoys Glass Wholesalers Pty Ltd is committed to complying with the provisions of the Protection of Personal Information Act (“POPIA”) in relation to the processing of your personal information. By providing your details in this form you acknowledge that any personal information you provide may be used, collected, and processed as is necessary for the establishing of a potential business relationship/agreement and the subsequent carrying out of actions and functions for the performance of the agreement. For details on how and why we collect, store, use, share, or otherwise process your personal information, and the rights in relation to your personal information, please refer to our Privacy Notice.

Online COD Application

Apply now to become a Trade Customer with McCoy's Glass

Documents Required with Form:

All COD Customers - payments must reflect in our bank account before any orders or deliveries will be made

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