Vinlab

Application Type

Application

Personal Details

Registered Company Name

First Name

Last Name

Confirm Email

Cell

Telephone It is highly recommended to supply two contact numbers to ensure the best possible service

Preferred Pickup Location:

Preferred Communication:

Email SMS

Physical Address

City/Town

Zip Code

Billing Information (Invoice and Statements)

Bill to Personal Information

Company to Invoice

Accountant Name

Accountant Telephone

Accountant Cell

Accountant Email

Address Line 1

Confirm Email

Address Line 2

VAT Number

Address Line 3

Reg Number

Address Line 4

Preferred Invoice Format:

Individual invoice (per PO number) Grouped invoice

Address Line 5

Create password

Terms and Conditions

The results of tests will be handled with absolute confidentiality by Vinlab, however due to our status of Accredited Laboratory the results have to be made available to SANAS and other legal parties on request.

I hereby accept these terms and conditions

Thank you for your registration!

Confirmation