Account application

Use this form to apply for an account with Civils & Drainage Supplies Ltd

Company name:

Company type:(Required)

Company Reg number (if Ltd):

Year established:

Company Address:

Street Address Address Line 2 City County Post Code Country

Company Phone Number:

Is this your Trading Address?(Required)

Trading Address: (if different from above)

Street Address Address Line 2 City County Post Code Country

Procurement Contact Name:(Required)

First Last

Phone(Required)

Email(Required)

Fax:

Name of Bank:

Address

Street Address Address Line 2 City County Post Code Country

Account Name:

Account Number:

Sort Code:

Credit limit required:

Please provide the contact details of two different suppliers who can provide a reference.

Trade Reference 1 - Contact Name:

First Last

Trade Reference 1 - Company Name:

Trade Reference 1 - Address

Street Address Address Line 2 City County Post Code Country

Trade Reference 1 - Phone number

Trade Reference 1 - Email

Trade Reference 2 - Contact Name

First Last

Trade Reference 2 - Company Name:

Trade Reference 2 - Address

Street Address Address Line 2 City County Post Code Country

Trade Reference 2 - Phone number

Trade Reference 2 - Email