Credit Account Application Form

Section 1 - Company Details

Business Name*

Business Address*

Post Code*

Telephone Number*

Type of Business*

Company Reg*

VAT no *

Turnover Last Year*

Invoice address the same as above* Yes No

Section 2 - Contact Details

Purchasing Contact*

Telephone Number*

Email*

Accounts Contact*

Telephone number*

Email*

Section 3 - Credit Details

Credit Amount Requested *

Anticipated Monthly Spend

How did you hear about us

Section 4 - Trade References

Company Name*

Address*

Contact*

Telephone numbers*

Company Name*

Address*

Contact*

Telephone numbers*

Company Name*

Address*

Contact*

Telephone numbers*

Section 5 - Bank details

Name of bank*

Address*

Sort code*

Account code*

Section 6 - Declaration

Signature* (sign in the box)

Name*

Position*

Date*

I accept the 30-day credit terms and confirm that I have read and agree to the terms and conditions Terms & Conditions.

Aggregates & Cement

Blocks

Bricks

Lintels

Chemicals, Sealants & Adhesives

Civils & Groundworks

Damp Proof & Ventilation

Fixings & Metalwork

Timber

Aggregates & Cement

Lintels

Blocks

Bricks

Damp Proof & Ventilation

Chemicals, Sealants & Adhesives

Civils & Groundworks

Access Products

Fixings & Metalwork

Timber