Business Details

Name of Applicant (*required)

Trading As (*required)

Business Address (*required)

Post Code

Telephone (*required)

Fax (*required)

Email (*required)

Previous Business Address

Company Registration Number (required if a limited company)

Nature of Business (*required)

Contact Name for payment of account (*required)

Telephone number for payment of account (*required)

Business Status (*required)

Limited CompanyPartnershipSole Trader

If Limited Company, please state

Address of registered office (if different from above)

Registered Office Postcode (*required)

Names of Two Principal Directors

Principal Director 1 (*required)

Principal Director 2 (*required)

Trading Date

Date Commenced Trading (*required)

Trade References

Reference 1 Name (*required)

Reference 1 Address (*required)

Reference 1 Telephone (*required)

Reference 2 Name (*required)

Reference 2 Address (*required)

Reference 2 Telephone (*required)

Reference 3 Name (*required)

Reference 3 Address (*required)

Reference 3 Telephone (*required)

Credit Limit Required

 Yes - Please tick if you require order no. quoted

£ (*required)

Please note that all our goods supplied are subject to a Reservation of Title clause, and that interest is chargeable on overdue accounts. Full details of standard terms and conditions are available here.

I confirm that I have read and understand the Standard Terms & Conditions of Trading, and in consideration of you having agreed to supply goods to the above named Applicant, I hereby guarantee payment of any accounts due and agree to be bound by the terms of trading: (*required)

Signed *
(*required)