Security Application form Couriers Online

Online Application Form

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Date
Date of request:
Company Details
Company Name:
Building Name/Number:
Street/Area:
Street/Area:
Town/City:
Postcode:
Contact Name:
Telephone No:
Account Contact Details
Contact Name:
Contact phone number:
Contact email address:
Invoicing Details
Invoicing Period:
Minimum Invoice Amount:
Signature Required:
Insurance:
Show reference on invoices:
Bank Details
Bank Name:
Account Number:
Sort Code:
Account Name:
Other Details
How did you hear about us?
Credit required (if left blank a £200 Limit will be attached)
Estimated Weekly Vehicle Usage: 1 - 9 10 - 34 35 - 59 60 - 99 100 + (give estimate)
Payment terms of 28 days from date of invoice. Overdue accounts subject to 3% per month. Account facilities will be granted but may be withdrawn without prior notice if the agreed credit terms are not adhered to. Submission of this application confirms I apply to open a Trading Account and agree that the transactions regarding this account will be subject to the above terms, which I have read and accept.



Data Protection Act. The information supplied will be used by Online-Couriers. for administration purposes. The information will be retained for the company's use only and no details will passed to any third party or used inappropriately. For further information contact kenobi@online-couriers.co.uk

Click here to Download print file and then fax or post it to us