UK New Customer Application - Non Limited Company

New customer account application form Non Limited Company

Please complete this form to apply for a customer account with Larson-Juhl UK Limited Unit 5 Bedford Link Logistics Park, Bell Farm Way, Kempston, MK43 9SS
Company Name*
Invoice Address*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Delivery Address (if different from invoice address)

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Proprietor's Name and Home Address *

Name

Street Address

CityCounty

Post CodeCountry
Main Contact person name*

First NameLast Name
Position of contact person*
Main email Address*
Main Telephone Number*

Area CodePhone Number
Pro-Forma paymentCredit Account
Application for Credit *

Credit Required £ Per month 30 day credit period

Bank Name

Sort CodeAccount Number

Bank Address
Person Authorising Application*

First NameLast Name
I have read the terms and conditions and privacy policy of Larson-Juhl UK Limited and herby agree to be bound thereby
Signature*

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New customer account application form Non Limited Company