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Proforma Account Application Form
Full legal entity name
*
Full trading name
*
Full trading address
*
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Trading address postcode
*
Delivery address if different to trading address
0 / 180
Delivery address postcode
Name of person placing order with MAC
*
Telephone number of person placing order
*
Email of person placing order
*
Accounts payable contact
*
Accounts payable telephone number
Accounts payable email
*
VAT number
Company registration number
Trading style
*
Please select an option
Sole Trader
Partnership
Limited Company
Terms of trade confirmation
*
I confirm that I am authorised to sign on behalf of the above company, or I am the proprietor of the above trading entity.
I confirm the information supplied is true and correct.
I agree to the terms and conditions of sale provided.
I agree that personal data provided concerning a director or proprietor may be used for credit checking where appropriate.
Authorised signatory
*
Signature date
*
Print name
*
Position
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