This form must be completed in full by a Director, Partner, Sole Proprietor or an Authorised person.
Company Name: *
Select business type: *
---Sealant ApplicatiorSealant Applicatior/DistributorGeneral DistributorBuilders MerchantGlazier/Glaziers MerchantMetal Window ManufacturerGlass Systems/Sealed Unit ManufacurerTimber Window & Conservatory ManufacturerUPVC Window & Conservatory ManufacturerMain Building ContractorSub-ContractorMarine DistributorTransportation/AutomotivePre-Fabricated Buildings ManufacturerLocal AuthorityOtherSpecialsFire PreventionIndustrial
Post Code: *
Email to receive company communication:
Invoice Address (if different):
Email to receive invoices and statements: *
Company registered in the UK?: *
Company Reg No: *
VAT Registration No:
If Partnership: Please enter your full name, home address with post code and date of birth.
If Sole Trader: Please enter your full name, home address with post code and date of birth.
Part of a Group:
Credit Limit: *
I / WE CERTIFY THAT IF CREDIT FACILITIES ARE GRANTED I / WE ACCEPT FULL RESPONSIBILITY FOR ALL PURCHASES FROM ADSHEAD RATCLIFFE & CO. LTD AND THAT THE ACCOUNT WILL BE CONDUCTED IN ACCORDANCE WITH OUR TERMS AND CONDITIONS WHICH ARE STRICTLY 30 DAYS FROM THE END OF MONTH.
Authorised Signatory: *
Name in Block Capitals: *
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