CREDIT APPLICATION FORM

www.astrumwinecellars.com

Unit 6 & 7 - Falcon Business Centre, 14 Wandle Way, Mitcham - Surrey CR4 4FG

AWRS Reg.No: XFAW00000100370
CREDIT APPLICATION FORM

Please ensure that ALL information is completed in full
We aim to process all new CAFs within 5 working days providing that all fields are completed in full
COMPANY INFORMATION
Registered Company Name:*
Company Registration Number:*
Trading As:*
VAT Number:*
Invoice / Statement Address:*
AWRS Reg.No:*
Accounts Contact Name:*
Accounts Contact Number:*
Invoice Email Address*
DELIVERY INFORMATION
Delivery Address:*
Postcode:*
Delivery Instructions:*
Onsite Contact Name:*
Contact Number:*
Email Address:*
TRADE REFERENCES

2 x Credit References are required
Company Name:*
Email Address:*
Phone Number:*
Company Name:*
Email Address:*
Phone Number:*
COMMUNICATIONS
Our mailing list is our way of keeping our customers up to date with all relevant information and changes to our products and services - we will only contact you when we feel it is necessary to inform you of something important or beneficial to your company. The types of information we keep you up to date with is as follows: changes to our policies and procedures, product updates, new products and producers, upcoming events, offers, and promotions.
Do you wish to receive marketing communications from Astrum Wine Cellars? If yes, please agree to Astrum Wine Cellars' Privacy Policy and provide the email addresses you would like to receive communications. *
Email Address:
Email Address:
Email Address:
ACKNOWLEDGEMENT and SIGNATURE
Note: This form must be signed by a Director / Partner or Proprietor.
For and on behalf of (LTD Company Name):*
Title/Position*
Name (BLOCK CAPITALS)*
ASTRUM Sales Contact*
Date*

DayMonthYear
Date
Signature*

Clear
Please verify that you are human*
We aim to process all new CAFs within 5 working days providing that all fields are completed in full
Should be Empty:

CREDIT APPLICATION FORM

COMPANY INFORMATION

DELIVERY INFORMATION

TRADE REFERENCES

COMMUNICATIONS

ACKNOWLEDGEMENT and SIGNATURE