DF Wishart - Account Application

Business Customers only
To apply for credit facilities with us complete the form below, alternatively download our application form, fill it in and send it back to us.

D. F. Wishart & Co Ltd
New Account Application Form

Your Name

Company Name

Invoice Name

Invoice Address

Postcode

Statement Address (If Different)

Postcode

Delivery Address (If Different)

Postcode

Telephone Number

Fax Number

Email Address

Registered Company No

Registered Company Name

Registered Company Address (If Different)

Postcode

Name of Holding Company (If Applicable)

If Company is Unlimited: Name(s) and Home Addresses of Proprietors

How Long Has your Company Been Established?

Number of Employees

Nature of your Business

Person Responsible for Purchasing (if not you)

Person Responsible for Accounts

Credit Required - Under £250

Credit Required - £250-£2500

Credit Required - More than £2500

We will make a search with a credit reference agency, which will keep a record of that search and share that information with other businesses. We may also make enquiries about the principal directors with a credit reference agency.

Reference 1 Name

Reference Address

Reference Tel No

Reference Fax No

Reference 2 Name

Reference Address

Reference Tel No

Reference Fax No

Your Bank's Name

Your Bank's Address

Your Bank's Postcode

Delivery Requirements

Type of Premises

Contact Name for Deliveries

Telephone Number For Deliveries

Access for Delivery (Select All Applicable)

HGV Access?

One Way Street?

Parking Restrictions?

Turning Circle Restrictions?

Height Restrictions?

Width Restrictions?

Conditions for Delivery (Select All Applicable)

Hard Hat/Hi-Viz/Banksman site?

Forklift/Pallet Truck Available?

Booking In Required?

Special Timings For Delivery?

I'd like to receive invoices and statements By EMAIL

I'd like to receive invoices and statements by FAX

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