Flooks waste management

Account Application

Fill in the form below and press SUBMIT
If you would prefer to send this form by post click here to download a PDF document which can be printed out, filled in and posted to us.
Company Name
Company Address
Registered Office (if different from above)
Telephone Number
Fax Number
Company Reg. Number
VAT. Number
Date Business Formed
Name, Addresses, Tel Numbers of Directors or Partners
Partner 1
Partner 2
Bank Name & Address
Bank account No.
Bank Sort code
Two trade references with addresses, Tel. No's, & Contact names
Trade Reference 1
Trade Reference 2
Person responsible for account payment
Credit required per month
Have you dealt with our company previously in any capacity? (ie another firm under a different name, as an employee of a customer of ours etc.)
If YES please give details
DECLARATION BY APPLICANT I/We hereby apply to open a credit account. I/We declare that the above details are true and correct to the best of my/our knowledge. I/We authorise you to approach a credit reference agency, bank and referees. I/We undertake to pay in full any monies due in accordance with your stated credit terms. I/We further agree to abide by your terms and conditions and understand this is the essence of the contract between us.
Name
Date