Applicant Name: ABN definition
Applicant Name: ABN. Address: Facsimile: Email: [insert name of pharmacy owner] [insert] [insert] [insert facsimile number] [insert email address] Pharmacy Name: Address: Approval No: [insert trading name of pharmacy business] [insert] [insert] DATED EXECUTED by #[insert Applicant name]# by its duly authorised representative in the presence of: ) ) Signature of Witness Signature of Applicant Name of Witness (print name) Introduction A The Guild identifies and secures opportunities for the delivery by Members of a range of health products and services to the Australian public in respect of programs that are sponsored by governments, governmental agencies and businesses, and other entities. The Guild will from time to time enter into services and other contracts for the delivery of health products and services. B You are a Member and wish to participate in Programs. You have applied to be registered by the Guild as a Service Provider. C These terms and conditions are to be read in conjunction with the Program Rules for those Programs you participate in from time to time. Operative Provisions