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Phone: (029) 2038 7406
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New Customer Details
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New Customer Details
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Business Name
*
Trading styles (if any)
Business Type
*
Limited company
Sole trader
Partnership
Company registration number (if applicable)
Website
VAT registration number (if applicable):
Years trading
Registered address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Is your trading address different?
Yes
Is your billing address different?
Yes
Trading address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Billing address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Main contact
Name
*
Telephone
Mobile
Email
*
Is your billing contact different?
Yes
Billing contact
Name
*
Telephone
Mobile
Email
*
Email recipients
Sales Order
*
Invoice (if different)
Statement (if different)
Must we quote your PO number on our invoices?
Yes
No
Request credit limit?
Yes
No
Our payment terms are 30 days from date of invoice
Requested credit limit
Selected Value: <b>£</b>
0
Our enquiries and management of your credit facility might affect your credit rating.
Optional extra information
Trade reference 1
Business name
*
Years trading with this business
Contact name/position
*
Telephone
*
Trade reference 2
Business name
Years trading with this business
Contact name/position
Telephone
Sweep site 1 (if required, please complete all fields)
Address
Contact name
Mobile
Email
Important notes
Sweep site 2 (if required, please complete all fields)
Address
Contact name
Mobile
Email
Important notes
I confirm that the information provided in this form is true and accurate
*
Yes
No
I confirm that I have read and understand your terms and conditions of business and I unconditionally accept that those terms and conditions apply to all business that I may conduct with you
*
Yes
No
Click here to read our Terms and Conditions
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Name
*
Email
*
Position
*
Date
*
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