New Account Application Form Centurion Europe Limited
Centurion House Hunt Lane Doncaster DN5 9SH Tel: +44 (0) 1302 788700 Fax: +44 (0) 1302 390004 sales@centurioneurope.co.uk
Please complete in BLOCK CAPITALS Date:
Company Name: Company Address:
Key Contact Name: Mobile No: Email address: Director(s)/Partner(s):
Telephone No:
Email address:
Facsimilie No:
Accounts Contact:
Are you a Limited Company?:
Email address:
Registration No:
Buying Contact:
VAT Reg No:
Email address:
Reg. Office address:
Years Trading:
(If different from above)
Website address: Buying / Invoice Group:
Nature of business:
Would you like to receive back orders?
Amount of credit required:
Where did you hear about us?:
References 1. Trade name:
2. Trade name:
Address:
Address:
Tel:
Fax:
Tel:
Fax:
Bank Details Bank Name:
Account No:
Address:
Sort Code:
Terms & Condition
I confirm that I have read, understand and agree to all terms and conditions as detailed in the Centurion Europe Limited Terms & Conditions reference CENT/TC07/20. Name (Printed):
Date:
Name (signature):
Position:
Please note: This account application cannot be processed without an official signature accepting our Terms & Conditions. Please contact our Sales office to request a copy.
For Office Use only
Credit Limit:__________________
Authorised by:_____________________________________
Account No:__________________
Area:____________________________________________
APP-CENT/TC07/20