Waitomo Fuel Account Form | CSC Buying Group

E: office@csc.org.nzP: (07) 823 7979

Fill out the form here and we'll be in touch.

Complete the form to apply for your Waitomo Fuel Card. Please note, this is still a trial so requirements may change.

If you require more than two cards please email accounts@csc.org.nz

We also require you to complete this Direct Debit form. Please return to accounts@csc.org.nz

Business/Organisation Name

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Contact Name

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Contact Email

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Contact Phone

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Postal Address

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Company Landline

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Email for Invoices to be sent

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Estimated Monthly Spend

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Company/Organisation name on Card (max. 20 characters)

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Vehicle/Reference CARD 1 (max. 10 characters)

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PIN Number CARD 1

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Fuel Type CARD 1

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Limit Per Transaction CARD 1

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Vehicle/Reference CARD 2 (max 10 characters)

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Pin Number CARD 2

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Fuel Type CARD 2

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Limit Per Transaction CARD 2

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E: office@csc.org.nz

P: (07) 823 7979

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