Trade Account Application

  • Sharlene Ltd
  • Unit 4
  • 97 – 101 Peregrine Road
  • Hainault Business Park
  • Hainault
  • ESSEX
  • IG6 3XJ

  • Tel: 0208 501 2642
  • Fax: 0208 501 0137

Please fill in this form and send it to us, alternatively, download and print out our PDF Version and fax it back to us. (*Indicates required fields.)


*Your Name:

Title:

Position:

Company Name:

Trading Name (if different):

Type of Business:

Address:

 

 

Town:

County/State:

Post Code:

Country:

*Email:

*Tel:

Fax:

Website:

No of Years Trading:

Co Registration No:

VAT No:

Bank:

Address:

 

 

Account No:

Sort Code:

Trade Reference 1:

Account No:

Address:

 

 

Tel:

Fax:

Trade Reference 2:

Account No:

Address:

 

 

Tel:

Fax:

From time to time we may wish to contact you in connection with other products we offer, please tick this box, if you DO NOT wish to receive these.