This form must be completed in full by a Director, Partner, Sole Proprietor or an Authorised person.
Company Name: *
Select business type: * ---Distributor / MerchantsMain ContractorRoofing ContractorFaçade ContractorLocal AuthorityOthers
Post Code: *
Email to receive company communication:
Invoice Address (if different):
Email to receive invoices and statements: *
Company registered in the UK?: * YesNo
Company Reg No: *
VAT Registration No:
If Partnership: Please enter your full name, home address with post code and date of birth.
If Sole Trader: Please enter your full name, home address with post code and date of birth.
Part of a Group:
Trade References Must be 2 Independent Companies (Recommended):
Credit Limit: *
I / WE CERTIFY THAT IF CREDIT FACILITIES ARE GRANTED I / WE ACCEPT FULL RESPONSIBILITY FOR ALL PURCHASES FROM CARLISLE CONSTRUCTION MATERIALS LIMITED (CCM Ltd) AND THAT THE ACCOUNT WILL BE CONDUCTED IN ACCORDANCE WITH CCM Ltd TERMS AND CONDITIONS WHICH ARE STRICTLY 30 DAYS FROM DATE OF INVOICE.
Authorised Signatory: *
Name in Block Capitals: *
T +44 (0) 1623 62 72 85 E firstname.lastname@example.org