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POST https://psicycling.applyeasy.com.au/contact/tr/1222537/6154

<form action="https://psicycling.applyeasy.com.au/contact/tr/1222537/6154" method="post" accept-charset="utf-8" class="form-horizontal">
  <ol class="form_sections">
    <li>
      <fieldset id="_section" class="form_section">
        <ol class="form_fields">
          <li class="control-group"><label for="tr_resp_intro" class="desc control-label" id="label_for_tr_resp_intro"></label>
            <div class="field controls" id="field_controls_for_tr_resp_intro">
              <div id="tr_resp_intro">
                <p><br>Ride Contour has applied for a credit account with our company and they have listed you as a trade reference. We would value your feedback and trading history with this organisation.</p>
                <p>Please submit answers to the questions below or if you would prefer to provide a verbal trade reference, please feel free to contact PSI Cycling Pty Ltd on 03 8327 8080</p>
              </div>
            </div>
          </li>
          <li class="control-group"><label for="tr_resp_trading_length" class="desc control-label" id="label_for_tr_resp_trading_length">Trading length</label>
            <div class="field controls" id="field_controls_for_tr_resp_trading_length"><select name="tr_resp_trading_length" id="tr_resp_trading_length" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="Not trading">Not trading</option>
                <option value="<1yr">&lt;1yr</option>
                <option value="1-3yrs">1-3yrs</option>
                <option value="3-5yrs">3-5yrs</option>
                <option value="5-10yrs">5-10yrs</option>
                <option value="10+ yrs">10+ yrs</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_ave_monthly_purch" class="desc control-label" id="label_for_tr_resp_ave_monthly_purch">Ave monthly purchases</label>
            <div class="field controls" id="field_controls_for_tr_resp_ave_monthly_purch"><select name="tr_resp_ave_monthly_purch" id="tr_resp_ave_monthly_purch" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="under $250">under $250</option>
                <option value="$250-$500">$250-$500</option>
                <option value="$500-$1,000">$500-$1,000</option>
                <option value="$1,000-$2,500">$1,000-$2,500</option>
                <option value="$2,500-$5,000">$2,500-$5,000</option>
                <option value="$5,000-$10,000">$5,000-$10,000</option>
                <option value="$10,000-$15,000">$10,000-$15,000</option>
                <option value="$15,000-$20,000">$15,000-$20,000</option>
                <option value="$20,000-$25,000">$20,000-$25,000</option>
                <option value="$25,000-$50,000">$25,000-$50,000</option>
                <option value="$50,000-$100,000">$50,000-$100,000</option>
                <option value="$100,000-$250,000">$100,000-$250,000</option>
                <option value="$50,000-$100,000_62f9daac5648d">$50,000-$100,000</option>
                <option value="$100,000-$250,000_62f9daac564e2">$100,000-$250,000</option>
                <option value="$250,000-$500,000">$250,000-$500,000</option>
                <option value="$500,000-$1M">$500,000-$1M</option>
                <option value="$1M-$2.5M">$1M-$2.5M</option>
                <option value="$2.5M+">$2.5M+</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_maximum_credit_limit" class="desc control-label" id="label_for_tr_resp_maximum_credit_limit">Maximum Credit Limit</label>
            <div class="field controls" id="field_controls_for_tr_resp_maximum_credit_limit">
              <div class="input-prepend"><span class="add-on">$</span><input type="number" name="tr_resp_maximum_credit_limit" value="" id="tr_resp_maximum_credit_limit" placeholder="Optional" maxlength="50" class="number" step="0.01"></div>
            </div>
          </li>
          <li class="control-group"><label for="tr_resp_account_terms" class="desc control-label" id="label_for_tr_resp_account_terms">Your account terms</label>
            <div class="field controls" id="field_controls_for_tr_resp_account_terms"><select name="tr_resp_account_terms" id="tr_resp_account_terms" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="No account">No account</option>
                <option value="Cash only">Cash only</option>
                <option value="7 days">7 days</option>
                <option value="14 days">14 days</option>
                <option value="30 days">30 days</option>
                <option value="45 days">45 days</option>
                <option value="60 days">60 days</option>
                <option value="90 days">90 days</option>
                <option value="120 days">120 days</option>
                <option value="Over 120 days">Over 120 days</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_conduct" class="desc control-label" id="label_for_tr_resp_conduct">Conduct of account</label>
            <div class="field controls" id="field_controls_for_tr_resp_conduct"><select name="tr_resp_conduct" id="tr_resp_conduct" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="No account">No account</option>
                <option value="Cash only">Cash only</option>
                <option value="7 days or less">7 days or less</option>
                <option value="8-14 days">8-14 days</option>
                <option value="15-30 days">15-30 days</option>
                <option value="31-45 days">31-45 days</option>
                <option value="46-60 days">46-60 days</option>
                <option value="61-90 days">61-90 days</option>
                <option value="Over 90 days">Over 90 days</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_traded_outside_terms" class="desc label_no_width" id="label_for_tr_resp_traded_outside_terms">Has the applicant traded outside your Trading terms in the last 12 months?</label></li>
          <li class="control-group"><label class="desc control-label"><span style="margin-left: 140px;top:-5px; position:relative;">↳</span></label>
            <div class="field controls" id="field_controls_for_tr_resp_traded_outside_terms"><select name="tr_resp_traded_outside_terms" id="tr_resp_traded_outside_terms" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="Yes">Yes</option>
                <option value="No">No</option>
                <option value="Unwilling to disclose">Unwilling to disclose</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_letter_of_demand" class="desc label_no_width" id="label_for_tr_resp_letter_of_demand">Have you ever had to serve a letter of demand for payment to the applicant?</label></li>
          <li class="control-group"><label class="desc control-label"><span style="margin-left: 140px;top:-5px; position:relative;">↳</span></label>
            <div class="field controls" id="field_controls_for_tr_resp_letter_of_demand"><select name="tr_resp_letter_of_demand" id="tr_resp_letter_of_demand" value="" maxlength="50" required="required">
                <option value="" selected="selected">Please select</option>
                <option value="Yes">Yes</option>
                <option value="No">No</option>
                <option value="Unwilling to disclose">Unwilling to disclose</option>
              </select><span class="a_req_field"><i class="icon-asterisk"></i> This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_comments" class="desc control-label" id="label_for_tr_resp_comments">Overall Comments</label>
            <div class="field controls" id="field_controls_for_tr_resp_comments"><textarea name="tr_resp_comments" cols="40" rows="10" id="tr_resp_comments" placeholder="" maxlength="1000" class="mce"></textarea></div>
          </li>
          <li class="control-group"><label for="tr_resp_name" class="desc control-label" id="label_for_tr_resp_name">Your Name</label>
            <div class="field controls" id="field_controls_for_tr_resp_name"><input type="text" name="tr_resp_name" value="" id="tr_resp_name" placeholder="" maxlength="250" required="required"><span class="a_req_field"><i class="icon-asterisk"></i>
                This field is required.</span></div>
          </li>
          <li class="control-group"><label for="tr_resp_position" class="desc control-label" id="label_for_tr_resp_position">Position</label>
            <div class="field controls" id="field_controls_for_tr_resp_position"><input type="text" name="tr_resp_position" value="" id="tr_resp_position" placeholder="" maxlength="250"></div>
          </li>
        </ol>
      </fieldset>
    </li>
  </ol>
  <div class="form-actions"><button name="submit_form_for_credit" type="submit" id="submit_form_for_credit" value="Submit" class="btn btn-primary" data-loading-text="loading...">Submit</button></div>
</form>

Text Content

Trade Reference Request
If you would prefer a verbal trade reference, please call PSI Cycling Pty Ltd on
03 8327 8080


 

 1.  1.  
         Ride Contour has applied for a credit account with our company and they
         have listed you as a trade reference. We would value your feedback and
         trading history with this organisation.
         
         Please submit answers to the questions below or if you would prefer to
         provide a verbal trade reference, please feel free to contact PSI
         Cycling Pty Ltd on 03 8327 8080
    
     2.  Trading length
         Please select Not trading <1yr 1-3yrs 3-5yrs 5-10yrs 10+ yrs This field
         is required.
     3.  Ave monthly purchases
         Please select under $250 $250-$500 $500-$1,000 $1,000-$2,500
         $2,500-$5,000 $5,000-$10,000 $10,000-$15,000 $15,000-$20,000
         $20,000-$25,000 $25,000-$50,000 $50,000-$100,000 $100,000-$250,000
         $50,000-$100,000 $100,000-$250,000 $250,000-$500,000 $500,000-$1M
         $1M-$2.5M $2.5M+ This field is required.
     4.  Maximum Credit Limit
         $
     5.  Your account terms
         Please select No account Cash only 7 days 14 days 30 days 45 days 60
         days 90 days 120 days Over 120 days This field is required.
     6.  Conduct of account
         Please select No account Cash only 7 days or less 8-14 days 15-30 days
         31-45 days 46-60 days 61-90 days Over 90 days This field is required.
     7.  Has the applicant traded outside your Trading terms in the last 12
         months?
     8.  ↳
         Please select Yes No Unwilling to disclose This field is required.
     9.  Have you ever had to serve a letter of demand for payment to the
         applicant?
     10. ↳
         Please select Yes No Unwilling to disclose This field is required.
     11. Overall Comments
         
     12. Your Name
         This field is required.
     13. Position
         

Submit

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