New Customer Registration Form
New customers can register by completing the form below. Once approved, you'll be ready to place orders with us. This should take 2-3 minutes.
Contact Details
First Name
*
Last Name
*
Surname
Role in Business
*
Business Owner/ Proprietor
Director
General Manager
Purchasing Manager/ Buyer
Restaurant/ Bar Manager
Hotel Manager
Head Chef/ Executive Chef
Accounts Manager
Other
Mobile Number
*
Please enter a valid mobile number (087 1234 567)
Format: 000 0000000.
Main Email Address
*
For invoices, statements, credit notes and account-related correspondence and order confirmations. If consent is given, you’ll also receive news, offers and updates by email.
Trading Name
*
Registered Company Name (if different)
Company Registration Number (CRO)
Example: 123456 or 12345
VAT Registration Number (If applicable)
Example: IE1234567A. If you are not VAT registered, please enter N/A.
Business Type
*
Coffee Shop / Café
Restaurant
Fast Food / Takeaway
Bakery
Hotel
Pub / Off-Licence / Nightclub
Retail Shop
Supermarket
Wholesale
Hospital / Care Home
Office / Workplace Canteen
Food Truck
Sports Club
Charity / Non-Profit Organisation
Other (Please Specify)
If other, please specify type
Years Trading
Example: 16 years
Business Address
Address Line 1
*
Address Line 2
Town/City
*
County
*
Eircode/Postcode
*
N37 1234
Delivery Address (if different)
Please include Eircode.
How Did You Hear About Us?
How did you hear about us? (select all that apply)
*
Existing Customer
Sales Representative
Google Search
Social Media
Trade Event
Online Advertisement
Other (please specify below)
Please specify how you heard about us
Privacy Terms
I agree to the
Privacy Policy
and
Terms & Conditions
*
Yes
No
Marketing Preferences
Would you like to receive offers, new product updates and seasonal specials from Seery's Cash & Carry? Please tick how you would like to hear from us:
*
Email
Phone Call
Promotional Email Address
*
Use my Main Email Address
Use a different email address
Alternative Promotional Email Address
*
Declaration & Signature
Declaration confirming information is true and accurate
Name
*
Position
*
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Digital Signature
*
Future Credit Account Interest
We may be interested in applying for a credit account in the future
Yes
No
New customer accounts are opened on a cash basis. Credit facilities may be considered after an established trading history and are subject to approval.
Submit
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