Business Account Credit Application Form
How did you hear about us? Please tick the appropriate box(es):
Word of mouth
Online search
Advertisement
Social media
Other
Company Name
*
Trading Name:
Company Number:
Vat Number:
Phone Number
Format: (000) 000-0000.
Mobile Number
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
County
Postal / Zip Code
Company Type
*
Limited Co.
Sole Trader
Number Of Years In Business:
Credit Limit Request:
Have you previously traded with Northwood Technology under any other name, company, or entity? If yes, please provide details:
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Business and Credit Info
Accounts Payable Contact
*
First Name
Last Name
Accounts Payable Phone
*
Format: (000) 000-0000.
Accounts E-mail
*
example@example.com
Bank Name
*
Bank Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
IBAN:
BIC:
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Business References
Trade reference mandatory as they are crucial for our assessment process. Please provide references from businesses similar to yours, if possible.
Internal Northwood Reference or Contact (if applicable):
Reference 1: Company Name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Type of Account
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Agreement
(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms
*
I hereby authorise Northwood Technology Ltd to contact the above organizations to obtain the required credit reference on my behalf.
Agreement and Terms
*
I have read and agree to the attached Terms and Conditions.
Agreement and Terms
*
Under GDPR regulations, I give permission for the information in this credit application to be held on file by Northwood Technology. All personal information we store is protected and will only be used in accordance with the terms of our privacy policy.
Signature
Submit
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