Farmlands Card Partner -
Expression of Interest Form

Page 1

What you need to know about becoming a Farmlands Card Partner!

Becoming a Farmlands Card Partner gives you access to Rural NZ, and connects you with up to 80,000 shareholders and 165,000 cardholders.

For over 60 years, with Partner exclusive offers, rebates, and incentives, our shareholders have benefited from significant savings and the ability to transact via their very own Co-op.
Farmlands is a buying group, charged with delivering value to our shareholders and Partners alike. Our shareholders look to Farmlands to deliver the best value for them and when Partners provide a compelling shareholder offer they too benefit from increased sales revenue.

We encourage you to consider the opportunity to become a Card Partner and provide details of your compelling shareholder offer on page 4.

Once this expression of interest form has been submitted it may take up to four weeks for initial contact to be made by the Farmlands Card team. The team try to make contact sooner than this, where possible.

Thank you for your interest in becoming a Farmlands Card Partner!

Note: Any application to become a Card Partner is not guaranteed. Each application is reviewed and considered in respect to the shareholder offer, commercial terms and any conflict with existing Partners.

Purpose of document

This expression of interest document is for businesses who wish to become a Farmlands Card Partner, and enable the Farmlands Card as a form of payment.

Should you wish to become a Farmlands shareholder you need to complete a different document, found here.

Acceptance

I have read the above information, I understand and agree to continue.

Yes, click next page to continue.If you do not agree then please do not continue with the document.

Page 2

Company Details

Legal Name

Trading Name

GST Number

NZBN (Find here)

Company Number (Find here)

Company Website

Example: https://www.mycompany.co.nz/

Landline and/or Mobile Number

Email Address

Are you a charity?

Charity Registration Number

Address Detail

Physical Address: Street Name and Number

Any offshore enquiries need to be communicated by email.

Town / City

Post Code

Postal address is the same as physical address?

Postal Address: Street Name and Number

Town / City

Post Code

Key Contact Information

Contact Name

Position in company:

Email Address

Landline and/or Mobile Number

Farmlands Relationship

Are you currently a Farmlands Shareholder?

Shareholder Number

9 digit number found on your Farmlands statement

Any other accounts with Farmlands?

Example: Current supplier

Page 3

Tell us about your business and what you sell or do

Please provide a brief description of your company and/or your products or services:

Please be descriptive so we know exactly what you sell and/or do.

Let us know why our shareholders would benefit by having your company as a Card Partner:

It's important for us to understand what product/service offering you have to our Shareholders and what you provide a solution for.

Please list your main competitors?

Example: Company A, Company B, Company C.

Feel free to upload a brochure or document to assist us to understand your offering.

Estimated Annual Sales

If your business became a Farmlands Card Partner what is the estimated amount of annual sales:

Page 4

Coverage

Do you supply your product and/or service:

NationallyRegionally

Do you have more than one physical location?

YesNo

How many physical locations?

Do you sell over the phone:

Point of Sale and Online Technology

Instore Point of Sale Provider

Technology platform - example: Advanced Retail

Do you sell online?

Ecommerce Platform

Example: WooCommerce

Payment Gateway

Example: Windcave

Farmlands Shareholder offer:

The offer to the Farmlands Shareholder, that you outline below, will be indicative only and will be confirmed in any signed agreements. The better the offer the more likely that a Farmlands Shareholder will want to spend with your business.

Fixed Offer:
The x% discount to the Farmlands Shareholder is static and is applied by Farmlands to the Shareholders monthly statement.

Variable Offer:
The x% discount to the Farmlands Shareholder is variable and is applied by the Card Partner at Point of Sale, this discount needs to be shown on the invoice line detail.

How do you want the Farmlands offer to work?

Fixed OfferVariable Offer

What is the fixed offer you would like to have in place?

Please advise on the % off the RRP you are willing to offer as a flat rate.

What does a variable offer look like? Please advise on 2 or 3 key lines?

Example: Product A 10% off, Product B 15% off, Product C 20% off

Farmlands Card Partner - Expression of Interest Form

Page 1

What you need to know about becoming a Farmlands Card Partner!

Page 2

Page 3

Tell us about your business and what you sell or do

Page 4

Point of Sale and Online Technology

Farmlands Shareholder offer:

Farmlands Card Partner -
Expression of Interest Form