Sidney Wholesale Customer Account Application Form

Business Name (including all trading names):

Limited Company Name: Company Registration Number: Date Registered: Name of Directors: Business Address: Post Code:

Sole Trader/Partnership Name: Home Address: Business Address: Post Code:

Business Type: Invoice Address & Postcode: Delivery Address & Postcode: Telephone: Fax (Optional): Email: Website (Optional): Buyer’s Name: Buyer’s Email: Buyer’s Contact Number: Accounts Contact Name: Accounts Email: Accounts Contact Number: VAT Registration Number (Optional): Office Opening Hours: Buying Group Memberships (Optional):

Trade References

Trade Reference 1

Business Name: Address: Telephone Number: Email Address:

Trade Reference 2

Business Name: Address: Telephone Number: Email Address:

Bank Information

Bank Name: Bank Address:

Account Number: Sort Code: Account Name:

Date: Name: Position: