National Glass - Customer Fact Sheet Survey

Select one of the following customer categories with an X: (We are B2B and only deal with customers who derive their income mainly from Glass and Aluminium products)

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* 7. Category:

Other (please specify)

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* 8. Memberships No:

AAAMSA

SAGGA

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* 9. Physical address of business:

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

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* 10. How did you hear about us?

Google Search

Website

Social Media

Referred by friend

Other (please specify)

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* 11. Fact sheet received from?

Website

In Branch

Sales Executive

Other (please specify)

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* 12. If answer to above is "Sales Executive", please select their name:

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* 13. Delivery Address: (Specify on order)

Site

Your Warehouse

Collection

Contact Details:

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* 14. Owner of business:

Name:

Tel no:

Cell no:

Email:

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* 15. Accounts Department:

Name:

Tel no:

Cell no:

Email:

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* 16. Buyer:

Name:

Tel no:

Cell no:

Email:

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* 17. Notifications:

Name:

Cell no:

Email:

Banking Details:

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* 18. Banking Details:

Name of Bank:

Account Name:

Account Number:

Branch:

Branch Code:

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* 19. Payment Method: (Regrettably no cheques accepted)

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* 20. What products do you buy:

Stock Sheets

Processed Glass

Aluminium

Extrusions

Flyscreens

Machines

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* 21. Popular Product Purchases:

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* 22. Orders placed via:

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* 23. Order numbers used:

Yes

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* 24. Who is authorized to purchase:

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* 25. Only delivery notes on delivery:

Yes

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* 26. SMS notification on order confirmation:

Yes

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* 27. SMS notification on delivery:

Yes

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* 28. Last 3 projects completed references:

By completing this you give National Glass your consent/permission to create your customer account on the National Glass Online Portal in order to view your profile and access, Invoices | Signed POD's | Track Orders | View Specials | View Price Lists and more.

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* 1. Registered Name of Business

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* 2. Business Registration Number:

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* 3. Trading Name:

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* 4. VAT Number:

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* 5. Years trading in the industry:

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* 6. Type of Business:

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* 7. Category:

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* 8. Memberships No:

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* 9. Physical address of business:

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* 10. How did you hear about us?

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* 11. Fact sheet received from?

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* 12. If answer to above is "Sales Executive", please select their name:

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* 13. Delivery Address: (Specify on order)

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* 14. Owner of business:

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* 15. Accounts Department:

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* 16. Buyer:

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* 17. Notifications:

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* 18. Banking Details:

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* 19. Payment Method: (Regrettably no cheques accepted)

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* 20. What products do you buy:

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* 21. Popular Product Purchases:

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* 22. Orders placed via:

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* 23. Order numbers used:

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* 24. Who is authorized to purchase:

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* 25. Only delivery notes on delivery:

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* 26. SMS notification on order confirmation:

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* 27. SMS notification on delivery:

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* 28. Last 3 projects completed references:

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* 29. Form Completed By:

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