Application for a Credit Account

Please fill in ALL fields, then click 'Send Form'.
(Fields marked * are optional)

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Note: This form is not sent over a secure connection.  If you don't wish to send your details this way, please download the form in Word format, complete it and fax it to us at: 01323 639444.
[ Click here to download this form ]

 
     

Full name:

Position within company:

Trading address:
 

Post Code:

Telephone number:

  

Fax number:

*

E-mail address:

Home address:
(partnerships and sole traders only)

*

 

Post Code:

*

Date of formation:

  

Estimated monthly credit required:

  (£ Pounds Sterling)
     

Trade references:

    

Reference 1  
(Include Post Code)

Reference 2  
(Include Post Code)

Bankers name and address:
 

Post Code:

Bank account number:

  

Bank sort code:

  
     
     

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Elliot Office Supplies
41 South Street
Eastbourne
East Sussex
BN21 4UP