Installer Application Form

Installer Application: Contact Details

1. Company Legal Name:

2. Contact Person (Primary Installer/Owner):

3. Physical Address:

4. Business Telephone Number:

5. Accounts Email (for invoicing and reward updates):

Experience & Qualifications

6. Total Years of HVAC/AC Installation Experience:

7. Qualifications / Certification (e.g., SAQCC, relevant trade certification):

Credit & Purchase Terms

IMPORTANT: To qualify for credit, all approved installers must complete their first three purchases as cash/EFT before the credit facility is activated.

Credit Information (for post-qualification account setup)

8. Bank Name:

9. Account Number:

10. Estimated Monthly Purchase Spend (R):

Required Documentation (Max 5MB per file)

11. Upload Proof of Company/ID Registration:

12. Upload Proof of Qualification/Registration (e.g., SAQCC Card):

Program Terms & Agreement

I confirm I have read, understood, and agree to the Installer Program Terms, including Tier 1 Rates, Credit Policy, Rewards, and CK documentation requirements.

Full Name (Typed Signature):

Date (DD/MM/YYYY):