Trade & Wholesale Customers

Full Trading Title:*

Postal Address:*

Postcode:*

Telephone Number:*

Fax Number:

E-mail address*

Nature of Business:*

Co Registration:*

Co. Status

Please list as appropriate full name and home address of Director/Partners/Proprietors:*

1:

2:

3:

4:

Please give two trade references:

Trade Reference 1:*

Trade Reference 2:*

Bank Reference:*

Sort Code:*

Account No:*

Please note all references will be taken up

Average monthly credit required:*

Please open a credit account in the above name. It is agreed that all sums outstanding will be paid on the due date. Please note checks may be done on home addresses.

Name in Caps:*

Position:*

Date of Application:*