Apply for your own Forlongs Account

Please make sure you fill in all required (*) fields.

Your Details

Title * Mr Mrs Ms Miss Dr

First Name *

Middle Name

Last Name *

Date of Birth *

Email Address *

Landline Phone

Mobile Phone

Preferred Contact Phone *

Marital Status *

Please Attach Drivers Licence or Passport Please attach a photo of your Drivers License or Photo page of your Passport. If you are unable to upload a copy, please email this through to [email protected]

Current Residential Details

Street Address Start typing to search a New Zealand address; suburb, city and postcode will fill in when you pick a result.

Suburb

City *

Postcode*

Time at Address (Years/Months)*

Residency Status *

Home Status *

Current Postal Details Same as Above? * Yes No

Please Attach Proof of Address Please attach a copy of your power bill, rates invoice, payslip or bank statement. If you are unable to upload a copy, please email this through to [email protected]

Employment Details

Employment Type *

Referees

1. Nearest Living Relative or Friend in NZ

Not living at the same address as you.

First Name *

Last Name *

Current Residential Address *

Contact Phone Number *

Relationship to You *

2. Nearest Living Relative or Friend in NZ

Not living at the same address as you or the first person stated.

First Name *

Last Name *

Current Residential Address *

Contact Phone Number *

Relationship to You *

Your Spouse/Partner or Emergency Contact Person

Full Name *

Contact Phone Number *

Relationship to You *

Subscription Preferences

Would you like to receive your account statement via email? * If you choose Yes your account will receive a $5 credit automatically Yes No

Would you like to subscribe to our promotional emails re:special offers and interest free deals * Yes No

Privacy Consent

Your Name *

Date *

Your Drivers Licence Number *

Your Drivers Licence Version Number *

Bedroom & Bedding

Decor & Accessories

Dining & Lounge

Electronics

Hardware

Kids Dept

Major Appliances

Small Appliances

Personal Items

Sporting Goods

Bedroom & Bedding

Decor & Accessories

Dining & Lounge

Electronics

Hardware

Kids Dept

Major Appliances

Small Appliances

Personal Items

Sporting Goods