Credit Account Application

Please complete the form to submit an application for a monthly credit account (accepted subject to status).   Fields marked with a * are required (for the sections relevant to your application).


Limited Companies please complete the following (PO boxes are not acceptable)

Full Trading Title *
Ultimate Holding Company *
Company Registration Number *
Year of Formation *
Registered Office Address *

Sole Trader/Partnerships

please complete the following (applications may be refused without full details)
Your Full Name *
Your date of Birth *
Your Home Address *
Your Post Code *
Your Telephone Number *
Business Partner Details:
Full Name
Date of Birth
Home Address
Post Code
Telephone Number

Address for Invoices 

Invoice Address *
Post Code *
Address for Statements (if different)
Post Code
Are we to accept orders without order numbers? Please tick if Yes
Accounts Tel
Accounts Fax
Accounts Contact
Accounts email address
Can we send invoices and statements to this Accounts email address? Please tick if Yes

Orders Tel
Orders Fax
Orders Contact
Orders email address

Please give details of two Trade Referees:

Name & Address 1
Post Code 1
Tel 1
Fax 1
Name & Address 2
Post Code 2
Tel 2
Fax 2

Your Credit Requirements

Estimated monthly Credit required
£500 £1000 £5000 Over
To assist in our offering the best service for your business can you please answer the following questions:
Nature of business
Number of employees on site
Your Name *
Position *
Telephone *
Email *
Response to application to be sent to:
Invoice Address Statement Address
Please send me occasional emails containing the following (please tick):
- News
- Offers
- Marketing
- Competitions

DATA PROTECTION: Please note that we will make a search with a credit reference agency, which will keep a record of that search and will share that information with other businesses. For Limited Companies we may also make enquiries about the principal directors with a credit reference agency, by submitting this form you are giving us permission to make these enquiries. Any information provided will only be used for this purpose and will not be passed to any other parties.

Enter the text displayed in the grey box above (case sensitive)
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