The Shoprite Group Business Card Application

Applicant Details

    * Utility bill no older than 3 months in the name of the Business

    Max size: 5MB
    File type: (jpg, png, pdf)


    Applicant Contact Details

    Details of Authorised Representative

      * Green ID Book / ID Card

      Max size: 5MB
      File type: (jpg, png, pdf)


      Bank Account Details

      We require this information to assess your credit status:

        * Bank Statement / cancelled cheque / bank letter in the name of the Business

        Max size: 5MB
        File type: (jpg, png, pdf)


        Debit Order Authorisation

        Preferences

        e.g. Brackenfell


        Purchase Limit

          Please provide a scanned certified copy of the bank code for purchase limit applied for, this is not required if limit is zero.

          Max size: 5MB
          File type: (jpg, png, pdf)


          Signature

          I hereby confirm that all details supplied above are true and correct. I acknowledge that I have read and understand the Terms and Conditions of this application form and agree on behalf of the Organisation to abide by the rules governing the Shoprite Business Card. I confirm that I am duly authorised to make this application on behalf of the Organisation and that the Organisation has the necessary legal capacity to enter into an agreement with Shoprite Checkers (Pty) Ltd as envisaged.

          Your privacy is important to us. Please do not send us any information we have not requested. See our data privacy statement for more.