All fields are required. Please fill in form using BLOCK letters only.
/ /
Company Name
JAS or Capricorn
Account Number
User Details
Full Name
Position / Title
Phone Number
E-Mail Address
User Role
(Please Tick One Only)
Full Access Restricted Browse Only
- Full Site Access - Unable to View Order - Unable to Place Orders
History / Account Balance
Terms of Use
There is a limit of one username per company/account number. If you require additional logins, please contact
JAS Oceania (Head Office). Any customer believed to have distributed passwords, improperly used or breached
any of the conditions of use of the system may, at JAS Oceania’s sole discretion, lose or have removed, their
access to our online ordering system.
I have read and agree to abide by the terms of use above and at:
Please return this form to your local JAS Oceania branch or alternate method below:
eJAS Application Form
Online Access Request
JAS Oceania (Head Office)
PO Box 1369, Tullamarine, VIC, 3043
(03) 9317 2690
For Office Use Only:
Approved by ___________________________________
Date ____________________
Version 3.0