DESIGN: Arum Lily COLOUR: Yellow
Type of Company*CCPTYSole ProprietorPartnership
Registered Company Name*
Trading Name*
Registered Business Address*
Delivery Address*
Postal Address
Reg Number*
VAT Number
Accounts Email*
Telephone Number*
Fax Number*
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Accounts Person Name*
Accounts Tel*
Buyer Name*
Buyer Email*
Buyer Tel*
Financial Manager*
Financial Email*
Financial Tel*
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Bank Account Name*
Type of Account*
Name of Bank*
Branch Code*
Account Number*
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Director 1 Name* Director 1 ID Number* Director 1 Cell Number* Director 1 Email*
Director 2 Name Director 2 ID Number Director 2 Cell Number Director 2 Email
Director 3 Name Director 3 ID Number Director 3 Cell Number Director 3 Email
Director 4 Name Director 4 ID Number Director 4 Cell Number Director 4 Email
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Reference 1 Company Name*
Contact Person*
Contact Number*
Facility Value
Reference 2 Company Name
Contact Person
Contact Number
Reference 3 Company Name
Reference 4 Company Name
[cf7mls_step cf7mls_step-5 "Back" "Next" "Step 5"]Your Business Focus* DecoratorCurtain MakerUpholstererBuyerManufacturerOther
If other, please specify
Would you like us to appoint a consultant to keep in contact with you? YesNo
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Orders will only be placed on receipt of a official company purchase order. Where fabric is cut and then cancelled a surcharge of 20% will be applicable. All new accounts are opened on COD basis.
Name*
ID Number*
Date*
By ticking this checkbox, you confirm that you are duly authorised to accept the trading terms and to sign of on behalf of the abovementioned company. You also accept terms and conditions as set above and all information supplied is correct.* Yes
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Username or email address *
Password *
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