Application To Purchase Goods on Credit

Registered name:		Please enter your registered company name.

Trading name:		Please enter your trading name.

Nature of business:		Please enter the nature of your business.

Length of time in business:		Please enter how long you have been in business.

Address:		Please enter your address.

Tel:		Please enter your telephone number.

Fax		Please enter your fax number.

Email:		Please enter your email address.Please enter your email address.

VAT registration number:

Name of directors / partners:

Trade References: