Account Application Form

Request an account with Active Technology.  Main benefits include 30-day payment terms and credit allowances.  A downloadable document accompanies this form available as a PDF file; What is PDF?

Company Details
Representative Name
(Must match that signed on the associated Terms & Conditions)
Client Name
(e.g. Company name, Organisation, Individual; where applicable)
Trading Name
(if applicable)
Primary Address
 



(incl. Post Code)
Delivery Address
(if different from above)



(incl. Post Code)
Trading Since
(e.g. 12th February 1992)
Annual Turnover
 
Type of Business
 
Company Registration Number
(if applicable)
VAT Number
(if applicable)
Telephone Number
(please include all area codes)
Facsimile Number
(please include all area codes)

Authorised Personnel
Please list names of personnel authorised to request work to be carried out and place orders on behalf of your company. Please note we will not be able to carry out works from anyone that is not listed below.
Full Name Telephone / Ext. E-mail Address

Trade References
Reference 1 (2 required; not necessary for schools) Reference 2
Company Name




(incl. Post Code)		 Address



(incl. Post Code)
Contact Name
Contact Telephone
Years Trading

Credit Limit
Credit Limit Required      

Bank Details
Name
Address



(incl. Post Code)
Sort Code
Account Number

Finalisation
Important: After you send this form, by clicking "Request Account" below, completion of the Account application process is only made when we're in receipt of a signed hard-copy of our Terms & Conditions document (photocopies, faxes will not be accepted) - the printable PDF document will automatically start to download when you click Request Account.

All approved account applications will be reviewed subject to status.  Initial trade will be based on the following, Bankers Draft, Credit Card, On Line Transfer, Cash, strict 30-day terms will apply after 3 clear transactions.  All orders will be subject to the standard Terms & Conditions of Active Technology*.  Information provided on the application form may be used for the purpose of obtaining credit references.

* Active Technology is a trading name of Actopia Limited.


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