I/we hereby agree to pay all accounts on a strictly 30 days from invoice basis unless otherwise stated on the official invoice and in accordance with our standard terms and conditions. I/we understand that , should payment not be made according to these terms, the account facility will be revoked. I/we also agree that all the information contained within this application form is true. By submitting this form you agree to all these conditions. * To purchase certain licenced pharmaceuticals ( therapeutics in particular) you will be required to submit a copy of your registration certificate.