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MODIFY YOUR BUSINESS DETAILS (*) Field Required    Otherwise,  please fill only the the boxes that you wish to modify. Click here to display this form as a print-ready, pdf file (45Kb).

Business Name:*   Established (year): Address: (fill also this line if necessary) City:* State: * Victoria New S.Wales Tasmania South Australia ACT Queensland Western Aus. Northern Terr. Other Postcode: * E-mail: Website: Telephone 1:            Telephone 2: Mobile:             Fax:            Type of Business: (Select as many as necessary) Retailer Wholesaler Exporter Importer Trade services Professional services Community group Government agency or service Club or association Financial services Emergency services Entertainment Charity organization Educational Flea or Fair Market Retailer Classifications: (Please list) ei: Children Footwear, Ladies Footwear Products and/or Services: (Please list) ei: School Shoes, Boots, Fashion Children Shoes, etc Trading hours: (Include dates if applicable) Payment methods accepted: (Select as many as necessary) Cash VISA MasterCard Dinners Club BankCard American Express Debit card DEFT card Other cards Direct deposit EFT transfer Cheque Bank cheque B-Pay POST Billpay Money Order COD Other Any comment on your business: Manager: Please, fill in Contact Information below The contact information below is confidential, will not be made public in any on or off-line listing, and may be used by us to confirm with you the validity of the information in the form above and to verify that is being provided by someone authorized by the business. Contact Person:* Position:* Telephone:* E-mail:     Would you like us to inform you of future developments? YES NO

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