I certify that the above information is true and correct. I have read and understand the TERMS AND CONDITIONS OF TRADE (
Viewable Here) of A Natural Difference Australia Pty Ltd T/A ClinicalPRO which form part of, and are intended to be read in conjunction with this Customer Information Form and agree to be bound by these conditions. I authorise the use of my personal information as detailed in the Privacy Act clause therein. I agree that if I am a director/shareholder (owning at least 15% of the shares) of the Customer I shall be personally liable for the performance of the Customer’s obligations under this contract.