Nicholls & Clarke Group, Apply for a Credit Account

First Name*

Surname*

Company Name*

Trading Name

Sales Email Address*

Confirm Sales Email Address*

Accounts Email Address*

Confirm Accounts Email Address*

Company Type*

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Trade Type*

Number of Employees*

Years Established*

Annual Turnover (£)*

Contact Details

Telephone

Fax

Mobile*

Website

Invoicing Address

Address 1*

Address 2

Address 3

Town*

Postcode*

Have you lived at this address for more than two or more years?*
No Yes

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Payment Contact Name*

Payment Contact Telephone*

Buying Contact Name

Buying Contact Telephone

Do you have a Trade Cash Card?*
No Yes

Payment Method*

Initial Credit Limit Required*

Will official orders be mandatory?*
No Yes

Is the site address mandatory on invoices?*
No Yes

Have any of the directors/partners or Sole Trader been subject of bankruptcy or IVA or had any CCJ’s registered against them?*
No Yes

Do you wish to receive invoices / statements by email?*
No Yes

Bank Account Details

Bank Name*

Account Number*

Sort Code*

Trade Reference 1

Name*

Credit Limit*

Telephone*

Trade Reference 2(Optional)

Name

Credit Limit

Telephone

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We will require a signature from the applicant or signatory of the company in order to process the credit application. Please confirm your e-mail addresses below so that we can send a copy of your completed application form to sign, date and return to us using the details sent with your application.

Sales Email Address
Accounts Email Address