NIC UK Account Form

COMPANY NAME *

PHONE NUMBER *

Area Code Phone Number

MOBILE NUMBER

Area Code Phone Number

EMAIL *

example@example.com

WEB ADDRESS

www.example.com

ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal Code Country

TYPE OF BUSINESS *

COMPANY REGISTRATION NUMBER

VAT NUMBER

NUMBER OF YEARS TRADING *

HOME OR REGISTERED OFFICE ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal Code Country

DELIVERY ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal Code Country

DELIVERY TIMES *

: Hour Minutes AM/PM Option

Until

until : Hour Minutes AM/PM Option

DELIVERY INSTRUCTIONS

ORDER NUMBERS REQUIRED

YES NO

CERTIFICATE OF CONFORMANCE

YES NO

PAYMENT METHOD

BACS CHEQUE CARD

ANNUAL TURNOVER £

CREDIT LIMIT REQUIRED *

CONTACT DETAILS *

Name

Telephone number

Email address

Director/Proprietor

Purchasing

Accounts

Emergency

TRADE REFERENCES *

Company name

Contact Details

Email address

1

2

3

4

BANK ACCOUNT DETAILS *

Details

Account Name

Bank Name

Sort Code

Account No

I/WE AGREE THAT NIC ICE LTD MAY APPLY TO MY/ OUR BANK IN ORDER TO SEEK A REFERENCE SHOULD IT BE NECESSARY *

YES NO

CONTACT PERMISSION We'd love to send you exclusive offers and the latest products and info from NIC ICE LTD by email, post, SMS, phone and other electronic means. We'll always treat your personal details with the utmost care and will never sell them to other companies for marketing purposes. *

Yes please, I'ld like to hear about offers and services No thanks, I dont want to hear about offers and services.

POSITION *

Signature *

Clear