New Customer Registration Form
Customer Details:
Contact Name
*
First Name
Last Name
Company Name
*
Position
*
Date of Birth
*
Business Details
Type of Business:
*
Limited Company
Partnership
Sole Trader
VAT Reg No:
Company Reg No:
Main Business Address:
*
Street Address
Street Address Line 2
City
County
Postcode
Contact Number:
*
Please enter a valid phone number beginning with 0.
Format: 00000 000000.
Alternate Number:
Please enter a valid phone number beginning with 0.
Format: 00000 000000.
E-mail:
*
What region do you fall into?
*
North
South
Is your registered address different to your main business address?
*
Yes
No
If Yes please fill out below:
Street Address
Street Address Line 2
City
County
Postcode
Is your delivery address different to your main business address?
*
Yes
No
If Yes please fill out below:
Street Address
Street Address Line 2
City
County
Postcode
Is your invoice address different to your main business address?
*
Yes
No
If Yes please fill out below:
Street Address
Street Address Line 2
City
County
Postcode
Is your invoice e-mail address different to your main business address?
*
Yes
No
If Yes please fill out below:
Type of premises operated:
*
Showroom
Factory Unit
Work from home
Other
Is this premises?
*
Leased
Rented
Owned
Length of time established:
*
Please answer in years and months.
Have you traded under another name within the last three years?
*
Yes
No
If Yes please fill out below:
Has the Proprietor/Partners/Directors been bankrupt or been subject of a creditors arrangement or the subject of a court order within the last three years?
*
Yes
No
If Yes please fill out below:
Have you traded with us before?
*
Yes
No
If Yes please fill out below:
*
How did you hear about us?
*
Search Engine {Google, Bing etc.}
Social Media {Facebook, Youtube}
Marketing Letter/Magazine
Word of Mouth
Referral
Other
Current Monthly Turnover (excluding VAT):
*
Amount of Credit Requested:
In the instance that the credit requested cannot be given a personal guarantee will be required.
Payment Terms Requested
*
CWO
14 Days
28 Days
Other - Please Specify
Product Details
Which of these products do you currently buy in? (select all that apply)
*
PVCU
Timber
Aluminium
Do you consent to being contacted by email by CWG Choices Limited?
*
Yes
No
Submit Registration
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