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New Customer Form

Contact Name:

Company Name:

Contact Type (Operator, Installer, Builder?):

Trading Style (Ltd, PLC, Sole Trader?):

Name of Proprietor:

For Partnerships - Name of Partners (1):

For Partnerships - Name of Partners (2):

Invoicing Address:

Delivery Address:

Contact Telephone:

Email Address:

Account Code PSVG:

Account Code 1st Glass:

Account Code B&CG:

Payment Type:

RSM:

Account Application Form Sent:

Price Band:

Nearest DC:

Fleet Size: