Information Form
Customer Details
To be completed by all new customers or in order to update existing customer information.
This is not a credit application.
All information submitted via this form is subject to our Customer Privacy Policy. Complete policy may be obtained from horticulture.dicla.com. Information submitted will be used for quotation and invoicing purposes. The person completing this form hereby confirms that all information submitted is correct and current. By submitting this form you agree to the stipulations of the customer Privacy Policy.