Business Name
Address Line 1
Address Line 2

Telephone Mobile
Fax e-mail
Contact Position

Nature of business
VAT registration number
Company registration number
Number of years trading

Sole Trader Limited Company Partnership Other

Tick where applicable

Please complete the following if a credit account is required

Business Name
Accounts Address

Telephone Contact
Fax e-mail

Please note any missing information on this form may delay your application.

Credit accounts will take a few days to set up, no goods will be released until payment has been made or a credit account established and terms agreed.

If you would prefer to apply by fax, please download our customer application form and submit via fax to: 02380 665901



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