CREDIT APPLICATION FORM

* Required Field

COMPANY DETAILS

Company Name*

Company Address*

Company Tel No*

Company Fax No*

Company Email*

 

TRADING NAME (if different from reg.)

Trading Name*

Delivery/Invoice Address*

Delivery/Invoice Tel No*

Delivery/Invoice Fax No*

Delivery/Invoice Email*

 

Date Commenced Trading* (format dd/mm/yyyy)

Company Registration Number*

Trading Style*

 

PROPRIETOR DETAILS

Proprietor Full Name*

Proprietor Tel No*

Proprietor Date of Birth* (format dd/mm/yyyy)

Proprietor Address*

 

ACCOUNT DETAILS

Please confirm how you would prefer to order from us*

Please confirm how you are going to make payment*

Credit Limit Required*
£

Credit Terms Required*

 

CONTACT DETAILS

Please select as appropriate

Full Name

Mobile

Landline

Email

 

FINANCE MANAGER

Full Name*

Mobile*

Landline*

Email*

 

HEAD CHEF

Full Name

Mobile

Landline

Email

 

TRADE REFERENCES

Please provide the details of 3 companies which you currently regularly trade with on an account basis.

These companies must be based within the UK and have a good knowledge of your account. Please note that we do not accept references from competitors within our trade.

 

Reference One

Company Name*

Address*

Phone*

Fax*

Email*

Type of Account*

Length of Trade*

 

Reference Two

Company Name*

Address*

Phone*

Fax*

Email*

Type of Account*

Length of Trade*

 

Reference Three

Company Name*

Address*

Phone*

Fax*

Email*

Type of Account*

Length of Trade*

 

CONFIRMATION

We hereby agree to the following - to be signed by the Owner or Director

Applicant Name*

Applicant Position*

Email Address*

 

By signing this agreement you agree to this Company’s terms and conditions, details of which are available upon request.

Signed* (please use mouse or input device to sign)

Date Signed* (format dd/mm/yyyy)

 

 

Country Fresh Foods

Contact Details

Tel: 0114 248 1188

Email: sales@countryfreshfoods.co.uk

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