Greengates Builders Merchants

Credit Account Application Form

Please complete all sections and read Terms & Conditions of Sale.

Company type:
Legal title:
Trading name:
Nature of business:
Trading address:
Postcode:
Phone:
Mobile:
Fax:
Co. Registered No & Office:
Postcode:
Years trading:

Directors/Partners Details

Name:
Phone:
Address:
Date of birth:

Name:
Phone:
Address:
Date of birth:

Name:
Phone:
Address:
Date of birth:

Trade References

Company:
Telephone:

Company:
Telephone:

Credit Required Per Month

Amount:
£

Please attach a copy of your letterheaded paper

Attachment:
*
*
*
*
Print name:
Position:
Spam protection:
1RFRHAM984CPW8

Type or copy & paste the code you see on the left side.