Tel : 416 447-9515    l    Fax : 416 447-9520    l    E-mail: info@wicff.com

Submit the following form to set up your Wholesale International Couriers account

Accounts are activated within 24hours



Name :
TItle :
Company :
Street Address :
City :
  Province :
Postal Code :
 
Phone * :
  Fax :
A/P contact * :
Email :*

Please provide the following Bank Information:

Pay by check

Bank :
Branch :
Branch Mgr :
Phone :
  Fax :

Pay by credit card:

Card Type :
Card Number :
Name On Card :
Expiry Date :
  CVV :

Trade Reference 1

Company name :
Contact person name :
Last transaction amount :
Telephone No :