New Customer Application

New Customer Application
This application if successful will enable the applicant to trade with Glenkrag Ltd as a trade customer. It does not infer any automatic right to financial credit or extended terms.

It should be noted that Glenkrag Ltd welcome applications from new or established:
- Pet Retail Outlets
- Aquatic Retail Outlets
- Veterinary Practices
- Garden Centres
- Associated Pet Businesses e.g. Grooming Salons/Boarding Kennels & Catterys
- E-Commerce site operating from a valid commercial premises
We are not considering applications from:
- Businesses operating from a private address
- Businesses operating through a 3PL arrangement (e.g. Ebay, Amazon etc.)
By choosing Continue, you confirm that you meet the above criteria for trading with Glenkrag Ltd:*

Continue

Personal Information

All personal data is handled in line with the Data Protection legislation. Any personal information given will be held securely off our database and not shared with third parties. It will only be used in pursuit of a default on the account.
Applicant Name:*

First NameLast Name
Home Address:*

Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number:*

Area CodePhone Number
Check Yes to add additional Principals/Directors. No to Proceed.*

YesNo

Additional Principal(s) / Director(s) as required

All personal data is handled in line with the Data Protection legislation. Any personal information given will be held securely off our database and not shared with third parties. It will only be used in pursuit of a default on the account.
Applicant Name:

First NameLast Name
Home Address:

Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number:

Area CodePhone Number
Applicant Name:

First NameLast Name
Home Address:

Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number:

Area CodePhone Number

Contact Information

We require an account contact and a buyer contact.
Accounts Contact: (Person who is responsible for making payments and receiving statements/invoices.)*

First NameLast Name
Accounts Contact Mobile Number:*
Accounts Contact Email:*
example@example.com
Buyer/Orders Contact:*

First NameLast Name
Buyer/Orders Contact Mobile Number:*
Buyer/Orders Contact Email:*
example@example.com

Terms of Trade - Glenkrag Limited

Please take the time to read through our Terms of Trade.

Declaration
By signing this form I/We confirm that all information provided in this application form is true and accurate.

First NameMiddle NameLast Name
Date:*

DayMonthYear
I agree to receiving emails.

YesNo
Should be Empty:

Business Information