Texol Corporate Card Application

LOYALTY CARD APPLICATION FORM (Corporate)

SECTION I (Company Information)

Company Name: *

Date of Incorporation: *

Physical Address: *

Town/City: *

Section II (Contact Details)

Contact / Authorizing Name: *

Contact Phone No: *

Contact Email: *

SECTION III (Vehicle Details)

Driver Name: *

Phone No: *

Vehicle Make: *

Vehicle Registration Number: *

Preffered Pick up Location: *

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