New Account Application Form
Please complete in BLOCK CAPITALS
Date:
Are you a Limited Company?:
Would you like to receive back orders?
Amount of credit required: Where did you hear about us?:
References
Centurion Europe Limited Centurion House
Hunt Lane Doncaster
DN5 9SH
Tel: +44 (0) 1302 788700
Fax: +44 (0) 1302 390004 sales@centurioneurope.co.uk
Bank Details
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
Company
Key
Mobile No: Email
Email
Accounts
Email
Registration
Buying
VAT
Email
Reg.
Years
(If
Website
Buying
Invoice Group: Nature
1. Trade name: 2. Trade name: Address: Address: Tel: Fax: Tel: Fax: Bank Name: Account No: Address: Sort Code:
Company Name:
Address:
Contact Name:
address: Director(s)/Partner(s): Telephone No:
address: Facsimilie No:
Contact:
address:
No:
Contact:
Reg No:
address:
Office address:
Trading:
different from above)
address:
/
of business:
Account No:__________________ Credit Limit:__________________ Authorised by:_____________________________________ Area:____________________________________________
APP-CENT/TC07/20