Customer Application Form

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First Name, Middle Name, Surname
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I hereby confirm that I have the legal authority to complete this application on behalf of the applicant and that by entering my name and job title, it shall be deemed to have the same legal effect and validity as a handwritten signature in accordance with New Zealand law.
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This online application form must be completed by all new customers who wish to purchase goods and services on credit terms. It collects all the necessary information required by Absorb to set up your account, or your company's account, if your application is approved.

If your application is approved and credit terms are granted, payment will be due on or before the 20th of the month following the invoice date, without exception. Late or missed payments will result in your account being switched to a cash sale status.

Your monthly credit limit will be established based on your requested amount. Any orders exceeding this limit will require approval from Absorb's management.

Information Required
When completing this form, you will need to provide both personal and/or company details.

Please confirm your understanding and agreement.
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Company Information
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Requested limit
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If your Company Email is different from the Registrant Email added above - please enter below:
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tick all that apply






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Soletrader / Individual Information
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Full Name please
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Requested limit
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Sole Trader only
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If your Trading Email Address is different from the Registrant Email added above - please enter below:
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To complete the account opening process, we require proof of address. You can provide a PDF screenshot of any document that clearly shows it was sent to you within the last six months, and clearly identifies your name and address