Account Application Form

    Title*

    Are you?*

    If tenant, please provide landlord details - name, address and phone number

    Are you a gold card holder?

    If yes, client number & expiry on the back of your card

    Another family member or friend (not living at the same address) name, address, phone number and their relation to you*

    I agree to invoices being sent by E-mail*

    Terms of Trade - Click to view terms of trade:
    www.electraserve.co.nz/terms-of-trade

    I have read and agree to the terms of trade*

    Ashburton’s biggest fleet of electricians servicing all of Mid Canterbury
    From repairs to your iron to new home and dairy shed wiring, you can rely on ElectraServe and their workmanship – guaranteed!

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