Trade Account Sign Up

Trade Account Application

Please complete all fields to process your application

Trading Information

Trading Address(Required)

Street Address Address Line 2 City ZIP / Postal Code Country

Registered Address (if different)

Street Address Address Line 2 City ZIP / Postal Code Country

Purchasing Contact(Required)

Direct Line(Required)

Email Address(Required)

Accounts Contact(Required)

Direct Line(Required)

Email Address(Required)

Credit Limit Required(Required)

Please enter a number greater than or equal to 0.

Bank Details

Name of Bank(Required)

Sort Code(Required)

Account Number(Required)

Address of Bank(Required)

Street Address Address Line 2 City ZIP / Postal Code Country

Owner Information

1st Directors Name(Required)

2nd Directors Name (if applicable)

Date of incorporation(Required)

Turnover (last financial year)(Required)

Please enter a number greater than or equal to 0.

1st Owner/Partner Name(Required)

Home Address(Required)

Street Address Address Line 2 City ZIP / Postal Code Country

2nd Owner/Partner Name

Home Address

Street Address Address Line 2 City ZIP / Postal Code Country

Trade References

First Reference

Company Name

Contact Name

Address

Street Address Address Line 2 City ZIP / Postal Code Country

Telephone Number

Email Address

Monthly Spend

Please enter a number greater than or equal to 0.

Credit Limit

Please enter a number greater than or equal to 0.

Second Reference

Company Name

Contact Name

Address

Street Address Address Line 2 City ZIP / Postal Code Country

Telephone Number

Email Address

Monthly Spend

Please enter a number greater than or equal to 0.

Credit Limit

Please enter a number greater than or equal to 0.

Please note only FULLY COMPLETED FORMS will be assessed.

AUTHORISATION:

This form needs to be signed by a director, business owner, or a senior representative of the company.

The customer authorises Hill Pumps to contact the above reference suppliers for information regarding the customers trading history with them.

All prices of Hill Pumps are ex works net 30 days.

The customer has read, understood and agrees to the terms and conditions of Hill Pumps which are available upon request.

Are you authorised to sign this form?(Required)

Yes

Signed(Required)

Name (block capitals(Required)

Position(Required)

Date(Required)

Notice(Required)

I agree to the Terms and Conditions

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Apply for Trade Account

Trade Account Benefits

Exclusive Pricing

Priority Support

Marketing Resources

Trade Account Application

Company Information

Trading Information

Bank Details

Owner Information

Trade References

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