Legal Company Name*Trading or Business Name (if applicable)ABNTrust Name (if applicable)Physical Business Street Address Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Business TelephoneBusiness WebsiteDirector/Partner 1Name First Last Mobile PhoneEmail Enter Email Confirm Email Director/Partner 2Name First Last Mobile PhoneEmail Enter Email Confirm Email Do you require residential or commercial accreditation (or both)? Residential Commercial Current CEC registration numberElectrical Contractors Licence Number (if applicable)Solar industry history and experienceNumber of Staff1-23-56+Services you provide (e.g. solar installations, battery storage, off grid systems, electrical work, lighting, air conditioning etc)PV Solar Panel Brands you offerSolar Inverter Brands you offerBattery / Storage brands you offerOther product types and brands you offer e.g. batteries, storage, LED, lighting etcProduct and installation warranty or workmanship guarantee you provide (in years)Do you complete the installations yourself or do you use external sub-contractors?If you require Commercial supplier accreditation please provide details of two recent commercial installations you have completed e.g. the customers’ business name, customer contact details, the installation address, system installed etcDeclarations: Have any Director’s/partners ever been convicted for fraud or dishonesty, or, or been a Director of a company in liquidation or receivership, or been bankrupt, or had any industry membership or accreditation refused or cancelled? Please answer YES or NO, if YES please provide full details below.NoYesHave you ever traded under any other business name(s) in relation to solar marketing, sales, supply or installation? Please answer YES or NO, if YES please full provide details below e.g. the previous ABN, business name and reason for the change of name.NoYesHave any Director’s/Partners been refused accreditation by any bank or financial institution, or had their finance accreditation suspended or cancelled by any financial institution? Please answer YES or NO, if YES please provide full details below.NoYesHave any workplace lost time injuries occurred in connection with your business, or had any disputes before the Ombudsman, Fair Trading or similar, that occurred in connection with your business over the past three years? If YES please provide details below.NoYesPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.