Credit Account Application Form - Adlington Welding Supplies Ltd

Full Trading Name*

Trading Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Email*

If Ltd, Reg Office

Street Address Address Line 2 City County Postal Code Country

Company Registration Number

Principals/Directors*

Address Required On Statement

Street Address Address Line 2 City Country Postal Code Country

How Long Established?*

Trade Of Company*

Telephone Number*

Fax Number

If Not Ltd Company (The Names And Addresses Of Proprietors Or Partners)

REFERENCES

Name*

First Last

Company Name

Address*

Street Address Address Line 2 City County Postal Code Country

Telephone Number*

Email*

Fax Number*

Name*

First Last

Company Name

Address*

Street Address Address Line 2 City County Postal Code Country

Telephone Number*

Email*

Fax Number*

Bankers*

Account Number*

Agreement*

I/we the undersigned would like to open an account with Adlington Welding Supplies Ltd and request that we are supplied with goods on credit.
I/we understand the terms and conditions are nett 30 days from the date of the statement.
In pursuance of this request we acknowledge receipt of the "Terms and Conditions of Business" supplied to us and agree to abide by those conditions of sale governing any order or contract placed with Adlington Welding Supplies Ltd.

Date*

Signature*

Email*

Position*

Upload A Specimen Letter Heading To This Application*

Consent*

Name

This field is for validation purposes and should be left unchanged.