APPLICATION FOR A 30 DAYS NET CREDIT ACCOUNT

APPLICATION FOR A 30 DAYS NET CREDIT ACCOUNT
Before submitting, please ensure all sections are filled in accurately and don’t forget to tick the box confirming that you have read and accept our terms and conditions and signed the form at the end.

If you have any questions before you complete the form, please contact us.
COMPANY NAME*
CONTACT NAME*

First NameLast Name
POSITION*
ADDRESS*

Street Address

Street Address Line 2

CityCounty / State

Postal / Zip CodeCountry
TELEPHONE*
EMAIL ADDRESS OF BUYER CONTACT*
EMAIL ADDRESS OF PURCHASE LEDGER CONTACT*
COMPANY REGISTRATION No.*
VAT No.*
DATE BUSINESS ESTABLISHED*

DayMonthYear
Date
TYPE OF BUSINESS*
ESTIMATED AMOUNT OF CREDIT REQUIRED*
GBP (£)
BANK*
BANK SORT CODE*
BANK ACCOUNT No.*
TRADE REFERENCE No. 1*
TRADE REFERENCE No. 2*
How did you find out about FA Parkes?*
If Sales Rep, please state who.
Which of the following services provided by FA Parkes are you aware of? (tick all that apply)*

Assembly FacilitiesCNC MachiningApplication AssistanceGas Strut Consultation/ConfigurationOne Stop ShopPreviously unknownOther
Which of the following products did you know we sell?*

HingesLocksHandlesLatches & CatchesSealsDrawer SlidesGas Struts/Gas SpringsRotary DampersPreviously unknownStabilus PoweriseOther
Disclaimer

By submitting this application, I confirm that the information provided is true and complete to the best of my knowledge.

I understand that FA Parkes may use this information to assess my application and manage my account.

I confirm that I have read and agree to the company’s Terms & Conditions and Privacy Policy, and I consent to the processing of my data in accordance with these documents.
I hereby state that I have read and understood the terms and conditions.*

I agree.
Full Name*
Signature*

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