Trade Account Application Form

Trade Account Application Form
Thank you for your interest in opening a Trade Account with us at DMS Flooring Supplies. Please complete the below information and one of our team will review your application in due course. Once the necessary checks have been completed, you will be notified of the decision via email.
Which branch will you be using?*
How would you like to be serviced?*
Just so you know, you are welcome to use any of our branches
Approved Credit Limit
Application Date

DayMonthYear
Date

Company Information
Company / Trading Name
Business Type
Type of Trade
Business Address

Street Address

Street Address Line 2

CityCounty

Post Code
Company Contact Number
Company Email
example@example.com
Company Registration Number
Is the company VAT registered?

YesNo
VAT Number

Proprietor Information
Proprietor Name
Business Address

Street Address

Street Address Line 2

CityCounty

Post Code
Proprietor Contact Number
Proprietor Email Address
example@example.com
Date of Birth

DayMonthYear
Date

Delivery Information
Is the Delivery Address the same as the Company Address?

YesNo
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Delivery Contact Name
Delivery Contact Number

Market Information
Who are your current suppliers for flooring product?
How did you hear about us?

Business Sales - Terms and Conditions
Please read and accept our Business Sales Terms and Conditions below.

Trade Credit Application
Are you looking to apply for a Trade Credit facility?

YesNo
How much credit are you applying for?

Accounts Contact Details
Ordering Contact Name
Ordering Contact Number
Ordering Contact Email Address
example@example.com
Remittance Contact Name
Remittance Contact Number
Remittance Contact Email Address
example@example.com
Invoicing Contact Name
Invoicing Contact Number
Invoicing Contact Email Address
example@example.com

Trade References
Trade Reference Name
Trade Reference Contact Number
Trade Reference Email Address
example@example.com
Trade Reference Address

Street Address

Street Address Line 2

CityCounty

Post Code
Do you have another Trade Reference?

YesNo
Trade Reference Name
Trade Reference Contact Number
Trade Reference Email Address
example@example.com
Trade Reference Address

Street Address

Street Address Line 2

CityCounty

Post Code

Credit Account Terms and Conditions

Signature
Signature

Clear
Print Name
Position
Date

DayMonthYear
Date
Should be Empty: