Application for Trade Account

Trading name  *

Registered name (if applicable)  

Invoice address  *

   

   

Postcode  *

Company Registration no.  

VAT no.  

Tel. no.  *

Fax. no.  

Email  *

Website  

Parent company (if applicable):

Parent company name  

Address  

   

   

Postcode  

Please circle which of the following best describes your business activity: * 

Builder

Plumbing

Electrical

Roofing

Scaffolding

M&E

Other (specify below)

 

Brief nature of your business (200 chars max)

Enter contact details of the person responsible for purchasing.

Purchasing contact name  *

Purchasing tel. no.  *

Purchasing contact email  *

Enter contact details of the person responsible for accounts payable (if different to above).

Accounts payable contact name  

Accounts payable tel. no.  

Accounts payable contact email  

(NB Referees should be able to quote for credit figures comparable to those requested & should NOT be an associated company)

Referee 1.

Name  *

Address  *

   

   

Postcode  *

Telephone no.  *

Fax no.  

Referee 2.

Name  *

Address  *

   

   

Postcode  *

Telephone no.  *

Fax no.  

Amount of credit required £  *

We will send your invoices & statements electronically by email, please complete the following:

Email address for statements  *

Email address for invoices  *

Full Name  *

Position  *

Date  *

I/We have read and accept Gripfixings Ltd Trade Account Terms and Conditions  *