Application Form

If you wish to apply for a credit account with us, please fill out the following form, or if you prefer, print out our printable version and fax/mail it to us.

 

Organisation Details:
Trading Name
Address 1
Address 2
Address 3
Town/City
Country
Phone
Fax
E-mail
Is the company a Partnership
Limited Company
Sole Trader
If a limited company please provide address of registered office 
Address 1
Address 2
Address 3
Town/City
Country
Postcode
Company Number
Managing Director/Partner
Title
Surname
Forenames
Home Address 1
Address 2
Address 3
Town/City
Country
Postcode
Company Secretary/Partner
Title
Surname
Forenames
Home Address 1
Address 2
Address 3
Town/City
Country
Postcode
Expected monthly turnover
Are the premises licenced? Yes
No
How long has the applicant's business been in existence?
Trade References:

Please provide the names and addresses of two trade referees.

1.

 Contact Name
Organisation
Position
Address 1
Address 2
Address 3
Town/City
Country
Postcode
Phone
Fax

2.
Contact Name
Organisation
Position
Address 1
Address 2
Address 3
Town/City
Country
Postcode
Phone
Fax
Bank Details:
Bank Name
Branch Name
Address 1
Address 2
Address 3
Town/City
Country
Postcode
Account Name
Account Number
Sort Code