Please complete and submit the following registration form. Your registration number and password will be e-mailed to you. Please note that our minimum opening order value is £300.00.
Company Details
|
| Trading Name |
|
| Name of Principle Directors / Partners or Individual |
|
| Company Type |
|
Account Address Details
|
| Address |
|
| Town /City |
|
| County / State |
|
| Postcode / Zip Code |
|
| Country |
|
Contact Details
|
| Contact Name |
|
| Address |
|
| Town /City |
|
| County / State |
|
| Postcode / Zip Code |
|
| Country |
|
| Telephone No. |
|
| Mobile Telephone No. |
|
| Fax No. |
|
| Email |
|
| V.A.T. Number (EEC Customers Only) |
|
Delivery Address Details
(if different from above)
|
| Address |
|
| Town /City |
|
| County / State |
|
| Postcode / Zip Code |
|
| Country |
|
FOR LIMITED COMPANIES ONLY
Registered Office Details
|
| Address |
|
| Town /City |
|
| County / State |
|
| Postcode / Zip Code |
|
| Country |
|
References
For UK customers wishing to open a credit account please provide 2 trade references.
|
| 1st Reference Name |
|
| Telephone No. |
|
| Fax No. |
|
| 2nd Reference Name |
|
| Telephone No. |
|
| Fax No. |
|
|
|
