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Trade/Registered Interest Registration

This area has been designed for existing trades wanting Extranet website access, and trades interested in joining the Pattersons Group.

Trade Details
Trade/Company Name:

First Name:
Surname:

Locale:
Business Address:
Business Suburb:
Business Postcode:
Business Phone:
Business Fax:
Mobile:
Email Address:

Password: (Min 6 chars)

Trades provided: All Trades -or-
 Builder Electrician Plumber
 Painter Plasterer Roof Tiler
 Ceramic Tiler
 Other: 
Company Information
GST Number:
Registered for GST?:
Location
Please give a brief description of the areas you cover. For example: Auckland Metropolitan, Kapiti Coast, Hutt Valley & and surrounding areas etc.

Regions Covered:
Trade References
Please provide three trade references for your workmanship. These details will be kept confidential.

Company:Name:Phone:
Company:Name:Phone:
Company:Name:Phone:
Comments
General Comments: Please provide any information that may be relevant to this request. You may also choose to briefly describe your services.

Comments:
Home Contact Details
Home Address:
Home Suburb:
Home Postcode:
Home Phone:
Home Fax:
Bank Account Information
Account Number:
Account Name:
Account Branch:
License/Certification Details
Please provide details of your licenses/certifications held with various governing bodies.

Type:LBP No:Expiry Date
Insurance Details
Please provide details of all insurance policies held, relating to your company.

Insurer:Policy Number:Expiry Date
Public Liability ($):
Site Passport
Site Safe Passport No:Level:Expiry Date
Supporting Document Upload
Please upload any supporting documents, such as;
insurance policies, LBP, public liability, tax exemption and site passports.
Insurance Relationships
Do you in any capacity work for any insurers, loss adjusters or builders within the insurance industry? If so, please specify details:

Verification
In an effort to combat SPAM and ensure that all form submissions are submitted by an actual user, we have introduced a verification system. Simply type the characters you see into the box before submitting the form. If you are having trouble reading the characters, simply click the 'Load New Code' option which will create you a new image.
  Code Image - Please contact webmaster if you have problems seeing this image code
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