CUSTOMER ACCOUNT APPLICATION FORM

FULL COMPANY NAME:           

REGISTERED ADDRESS: 

	                                                                                                     TEL NO.                               

TYPE OF BUSINESS (tick appropriate box):        LTD.                SOLE TRADER		PARTNERSHIP       

INVOICE ADDRESS (IF DIFFERENT FROM ABOVE):

DELIVERY ADDRESS (IF DIFFERENT FROM ABOVE):  				                 

REG NO.:                                                                                                 VAT NO.: 
                                                                                                                            
YEAR OF INCORPORATION:                                                             ANNUAL TURNOVER £

IF SOLE TRADER/ PARTNERSHIP PLEASE PROVIDE FULL NAMES, HOME ADDRESSES, DATES OF BIRTH & TELEPHONE NUMBER(S) OF ALL PARTNERS (PLEASE USE A SEPARATE SHEET IF NECESSARY)

1.	__________________________________________________________________                  Date of Birth   _ _/_ _/_ _
		
           ____________________________________________ Tel: __________________

2.	__________________________________________________________________                 Date of Birth   _ _/_ _/_ _
           
           ____________________________________________ Tel: __________________

ACCOUNTS CONTACT & EMAIL ADDRESS:

PURCHASING CONTACT & EMAIL ADDRESS:

NATURE OF BUSINESS: 

COMPLETED BY & JOB TITLE:

SIGNATURE:							DATE: 

PLEASE COMPLETE BELOW IF REQUESTING CREDIT ACCOUNT

TRADE REF 1:							TRADE REF 2:			

ADDRESS 1:			ADDRESS 2:				

CONTACT 1:							CONTACT 2:

PHONE NUMBER 1:						PHONE NUMBER 2:

£ 

                                                              CREDIT REQUIRED: