Application Date Name/Company Trading As Address City Post Code Delivery Address (If same as above leave blank) City Post Code Telephone Mobile Email Website/URL Accounts Payable Contact Accounts Payable Email Accounts Payable DDI Terms of Service I/We Agree to Apex Medical terms of trade Find our Terms & Conditions Here: Terms & Conditions Customer Acknowledgements I/We hereby apply for a credit account with Apex Medical I/We understand that under your conditions of trade, full payment is due on the 20th of the month following the date of the invoice I/We agree that all goods remain the property of Apex Medical until full payment is received I/We agree that Apex Medical reserves the right to uplift unpaid goods at their discretion I/We consent to Apex Medical collecting any information that may be required to evaluate my/our credit worthiness Authorised Signatory Name Send