ACHESON & GLOVER LTD PERSONAL CREDIT ACCOUNT APPLICATION

Fields marked with a * are required fields. Your application will be processed quicker if all details are filled in.

PERSONAL DETAILS
Title: * (Mr / Mrs/Ms/Other)
Forename(s): *
Surname: *
Postcode:*
Telephone: *
Address:*
Mobile:
Fax: (if applicable)
Email: *
Date of Birth : *

BANK DETAILS
Bank Name:
Branch / Town:
Account Number:
Sort Code:

MARITAL STATUS
Status: *	Married
	Single
	Other
Previous / Maiden Name:

CURRENT OCCUPANCY
Status: *	Owner of Home
	Tenant
	Live with parents

Time at current Address:*	Years Months
Previous Address:
Previous Postcode

EMPLOYMENT STATUS
Status: *	Employed
	Self Employed
Occupation:*
Employer's Name: *
Employer's Address: *
Postcode: *


Time with Employer:* Years Months
(if less than three years please give previous occupation and employer)
Tel. No. *
Previous Occupation:
Previous Employer:
Time with previous Employer: Years Months

CREDIT LIMIT 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 guarentee payment of any accounts due and agree to be bound by the terms of trading:

SIGNED *