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ACCOUNT FORM



                                                                            Serious About Safety





          Customer Account Application Form





            YOUR BUSINESS DETAILS - (If you wish to open a BCS Group account, please complete and return with a sample of your official company letter headed paper)
            Full Company Name:                                             Company Reg No:
            Invoice/Statement Address:                                          VAT Registration No:

            Town:                                                               Trading Style: (please tick or state other)
            County:                          Post Code:                         Limited Company  PLC
            Website:                                                            Partnership     Sole Trader
            Nature of business:                                                 Government Dept/Institution/Professional Body
            How long have you been established?  Years  Months  Credit Limit Required: £  Other: (please tick box and state below)
            Credit Terms: 30 DAYS FROM INVOICE
            Trading Address: (if different to Invoice Address)  Delivery or Site Address:


            Town:                                             Town:
            County:                                           County:
            Post Code:                                        Post Code:
            CONTACT DETAILS
            Account Payable Contact Name:    Tel No:                           Fax No:
            Job Title:                       Email:
            Buying Contact Name:             Tel No:                           Mobile:
            Job Title:                       Email:
            TRADE REFERENCES
            Name:                            Name:                             Name:
            Address                          Address                           Address

            Post Code:                       Post Code:                        Post Code:
            Tel No:                          Tel No:                           Tel No:
            YOUR BANK DETAILS - PLEASE GIVE FULL DETAILS OF YOUR MAIN ACCOUNT
            Bank Name:                                                      Account Number:
            Account Name:                                                   Sort Code:         -       -
            Bank Address:                                                   Post Code:
            DECLARATION To be completed by a director(s) of a limited company/members of LLP
           This is a legal document. Do not sign this form unless you wish to be bound by our terms & conditions. The full version of our trading terms & conditions can be viewed at http://www.bcsgroup.co.uk.
           I / We hereby make application for a trade account with BCS Group. I / We agree to make payments in accordance with the terms & conditions offered. I / We authorise you to take up any trade references
           or make use of a credit reference agency in accordance with the Data Protection Act 1988.

            Signature:
            Print Name:
            Position:
            Date:                     /        /                 /        /                  /       /
            FOR OFFICE USE ONLY
            Account Number:                  Credit Limit Approved: £      Date Approved:    /       /
            Approved By:                                     Account Manager:


           Please forward this form when completed, either by post or email including a copy of your company letterhead  CF449-50 Version 4
           BCS Group: Registered in England and Wales, Company No 01808140. Tel. 01922 726726 Email. sales@bcsgroup.co.uk
           Registered Address: Barhale Construction Services Ltd, Bescot Crescent, Walsall WS1 4NN.


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