Credit Account Application Address Details Address Details Applicants Full Name Invoice Address Post Code Email Address Tel. Number Fax Number Delivery address same as invoice? Delivery address same as invoice? Yes No Delivery Address Company Details Company Details Company Name Company Registration Number VAT Registration Number EORI Reg Number (where applicable) Name(s) of Director(s) / Owner(s) / Partner(s) What year was the company founded? Type Of Business Type Of Business Sole Trader Partnership Charity Limited Company (Ltd) Public Limited Company Government company (i.e. Local Authority) Nature Of Business Nature Of Business Grower Retailer Wholesale Local Authority Other Please Explain Payment Details Payment Details Name of Bank Sort Code Account Number Local Bank Branch Address Preferred Invoice Currency Preferred Invoice Currency £ GBP € EUR Purchase Order Required on Invoice? Purchase Order Required on Invoice? Yes No Value of Credit Limit Required? (in £'s) Trade References Trade References Trade Reference 1 (address and tel. number) Trade Reference 2 (address and tel. number) Trade Reference 1 Email Trade Reference 2 Email Final Information Final Information Please sign and date the below to confirm you accept the following terms and conditions: Please sign and date the below to confirm you accept the following terms and conditions: I / We accept that any goods supplied will be in accordance with Kernock Park Plants Ltd "Conditions of Sale" - see link at base of this page I / We accept that any goods supplied will be in accordance with Kernock Park Plants Ltd "Conditions of Sale" - see link at base of this page Full name Date Submit