Credit Application Form
Full Trading Title
Company Name
*
Industry
Please Select
Agriculture
Construction & Roadworks
Conveyor - Distributor
Conveyor - End User
Conveyor - OEM/Installer
Education
Food & Drink
General Fabricator
General Machinist
Healthcare & Medical
Leisure
Packaging
Private Sale
Retail & Printing
Stockholder/Trader
Technologies
Transport
Utilities
Wall Cladding (Installer/User)
Wall Cladding (Stockholder/Trader)
Your Anglia Sales Advisor
*
Invoice Address
Address
*
Street Address
Street Address Line 2
City/Town
County
Post Code
Registered Name & Address
Is the registered company name and address different to the name and address provided on this form?
*
Yes
No
Registered Name
*
Registered Address
*
Street Address
Street Address Line 2
City/Town
County
Post Code
Delivery Address
Is the delivery address the same as the invoice address?
*
Yes
No
Delivery Address
*
Street Address
Street Address Line 2
City/Town
County
Post Code
Accounts
Accounts Payable Contact Name:
*
Accounts Email Address
*
example@example.com
Accounts Telephone Number:
*
Accounts Mobile Number:
Purchasing
Buyer Contact Name
*
Buyer Email Address
*
example@example.com
Buyer Telephone Number:
*
Buyer Mobile Number:
Trade Reference 1
Company Name
*
Address
*
Street Address
Street Address Line 2
City/Town
County
Post Code
Contact Name
*
First Name
Last Name
Telephone No.
*
E-mail
*
example@example.com
Trade Reference 2
Company Name
*
Address
*
Street Address
Street Address Line 2
City/Town
County
Post Code
Contact Name
*
First Name
Last Name
Telephone No.
*
E-mail
*
example@example.com
Other Information
Is the company registered?
*
Yes
No
Is the company VAT registered?
*
Yes
No
Company Registration Number:
*
VAT Number:
*
Names/Titles of Executives
*
Date of Incorporation
/
Day
/
Month
Year
Date
Amount of Credit Required (£)
*
Please attach a copy of your company letterhead (pdf, doc, docx, dotx, html, jpeg, png, gif, jpg)
*
Browse Files
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of
Goods In Contact Details
Name
*
First Name
Last Name
Contact No.
*
Delivery Address Opening / Closing Times
Do the opening and closing times vary throughout the week (Monday to Friday)?
*
Yes
No
Typical Opening and Closing Times (Monday- Friday)
*
Opening Time
Until
until
Closing Time
Monday
*
Opening Time
Until
until
Closing Time
Tuesday
*
Opening Time
Until
until
Closing Time
Wednesday
*
Opening Time
Until
until
Closing Time
Thursday
*
Opening Time
Until
until
Closing Time
Friday
*
Opening Time
Until
until
Closing Time
Additional Delivery Information
Please provide information on access issues, weight restrictions, or directions in the box below.
Does the delivery address have a forklift available?
Yes
No (a member of your team may be required to assist)
Signature
We apply for a Credit Account with Anglia Plastics Ltd subject to the Terms & Conditions of sale (linked below) and agree to honour the payment terms of 30 days end of month.
Full Name
*
First Name
Last Name
Position
*
Date
*
-
Day
-
Month
Year
Date
Sign
*
Submit Application
Submit Application
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