Timber Flooring, Hardwood Floors, Floating Floors and Hardwood Decking

Personal Details
	Title
*	First Name
*	Last Name
	Company Name
	Position in Company
	Tradespersons Licence No
	A.B.N

Mailing Details
*	Address
*	Suburb/Town
	State
*	Post Code

Contact Details (At least ONE phone contact is required)
	Business Hours
	After Hours
	Mobile No
*	Email Address

Activity Statements
	Activity Statements and Members Specials will be available online. You'll be able to view your latest point's activity information, as well as accessing the latest news and promotions as they happen. *NOTE: By subscribing, you have accepted the terms & conditions of the Frequent Floorer Program at www.northernriverstimber.com.au
Declaration
*	I understand that if all or any of the requested information is not provided, Northern Rivers Timber will not be able to provide the services to me and membership may not be granted. I wish to join the Northern Rivers Timber Frequent Floorer Program and confirm that I understand that my membership of Northern Rivers Timber Frequent Floorer Program is subject to and that I accept the Terms and Conditions at www.northernriverstimber.com.au/frequentfloorer. I consent and authorise Northern Rivers Timber to use and disclose all of the information on this application form and other information that I provide to Northern Rivers Timber for improving customer service, marketing, product development and planning in connection with the administration of the Northern Rivers Timber Frequent Floorer Program.