Contact - Account Application Form

General Information

Name of Company or Individual(Required)

Trading Name (if different)

Type of Business(Required)

Limited Company

Partnership

Individual

What region will your work be undertaken?(Required)

London and South East

Midlands

South West and South Wales

North East and North West

Scotland

Company Registration No.(Required)

Are You VAT Registered?(Required)

Yes

No

VAT Registration No.

Are You CIS Registered?(Required)

Yes

No

Unique Taxpayer Reference (UTR)

Site Questions

End User Status(Required)

Never an end user

End user

Site Address(Required)

Street Address Address Line 2 City County Postcode

Full Registered Address(Required)

Street Address Address Line 2 City County Postcode

Main Telephone No.(Required)

Main Office Email(Required)

Main Mobile No.(Required)

Accounts Information

Credit Limit Requested(Required)

Is the Accounts Address Different from the Registered Address?(Required)

Yes

No

Full Accounts Address(Required)

Street Address Address Line 2 City County Postcode

Name of Accounts Contact(Required)

Main Accounts Telephone No.(Required)

Main Accounts Email Address(Required)

Statement Email Address(Required)

Invoice Email for e-invoicing via Tradex(Required)

Commercial Information

Commercial Contact Name(Required)

Commerical Contact Job Title(Required)

Commerical Contact Email(Required)

Commercial Contact Telephone No.(Required)

When is Your Expected First Pour Date?(Required)

Date of First Pour(Required)

How did you hear about us?(Required)