wholesaler application form

If you are interested in becoming a Val Spicer supplier please fill in the form below so we can process you application and contact you regarding this opportunity.

 
 
Email /
*
Registered Company Name /
*
   
Trading Name / *
   
Registered Office / *
   
Invoice Address
(if different from registered office)
   
Full Name of / *
Director Partner Sole Owner
 
 
Director Partner Sole Owner
 
 
Director Partner Sole Owner
 
   
 
   
   
Registration Number /
*
   
   
Registration Date /
*
   
Nature of Business /
Name of Buyer /
   
Buyers Telephone /
   
Account Contact Name /
   
Contact Telephone /
   
Contact Fax /
   
Select Appropriate /
Sole Trader Partnership  
Limited Company Plc  
   
If Partnership / Sole Trader please state address /
And Telephone /
address Two /
And Telephone /
   
 
Trade References - Include Telephone and Fax Numbers
   
One /
Two /
   
Delarations - tick box to agree
   
THE APPLICANT WILL BE RESPONSIBLE FOR THE PAYMENT OF ANY INDEBTEDNESS WHEN THE ACCOUNT IS OPENED,IRRESPECTIVE OF WHO GIVES THE INSTRUCTIONS
IMPORTANT

•  Completion of this application does not imply or confer credit facilities

•  The company reserves the right to make further enquiries in connection with the application.

•  The company reserves the right to refuse credit on trading facilities.
THE INFORMATION SHOWN IN THIS FORM IS ACCURATE IN ALL RESPECTS I/WE AGREE TO ABIDE BY THE TERMS AND CONDITIONS SHOWN IN THIS FORM AND IN THE PRICE LIST OF VAL SPICER DESIGNS AND AS MAY BE AMENDED FROM TIME TO TIME.
   
 
Val Spicer
The Sugar Mill
Harford Bridge
Tavistock
PL19 9LR

+44 (0)1822 616612
info@valspicer.co.uk

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