Traders Account Form

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Date:

Vat Number:

In Business Since:

Channel Type - PLEASE MARK only one of the boxes below:
Beauty/Spa/SalonChildrenDepartmentalEcommerce/Catalouge/Mail order/TVEstate & SpecialtyFloristsGift/LifestyleGardenHealthPharmacySport/Outdoor

Buyer name & Contact details:


Head Office Contact Details:


Supplier References x2 mandatory - please fill out in FULL





OTHER INFORMATION: (any special agreements etc.)