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New Customer Account Form

About Your Business

Email:

Type of Business:

Legal Entity:

A
B
C
D

Company Registered Name:

Company Registration Number:

Company Registered Address:

Same Address For Deliveries?

A
B

VAT Registration Number:

Your Bank Details: Bank Name, Account Name, Sort Code and Account Number

Permission To Credit Check:

A
B

Business Structure

Number of Sites:

Number of Employees:

Annual Turnover:

Ordering Information

Please fill in all the applicable information

Order Types:

PRIMARY/BUYER CONTACT:

Full Name:

Email:

Telephone:

ACCOUNTS CONTACT:

Same as above?

A
B

ORDERS CONTACT:

Same as above?

A
B

LOGISTICS CONTACT:

Same as above?

A
B

Special Delivery Instructions:

Is there anything specific we need to know? Any special access, vehicle or booking in requirements?

Telephone for deliveries:

Trade References and T&Cs

Please fill in all the applicable information

Trade References:

Trade Reference #1

Business Name:

Trade Reference #2

Business Name:

Contact Name:

Contact Name:

Email:

Email:

Telephone:

Telephone:

Suggested Credit Limit PCM:

T&Cs - Please read them following the link below:

I have read and accepted this document:

Signature:

Signature

Full Name:

Position In Company:

How Did You Hear About Us? / Additional Comments: