Apply for a credit account

About you and your business

Company name *

Trading name (if different from above)

Date Established *

Address 1 *

Address 2

Address 3

Address 4

City *

County

Postcode *

Phone *

Email *

Are you a... *

Limited Company

Sole Trader

Partnership

Homeowner

Registered name *

Registration no *

Address of Registered Office *

Do you have any other accounts with us? If yes please include name of account or account number *

No

Yes

A/C name/number *

Names and home addresses

If directors/partners/proprietors/individual account application

To be completed by proprietor, partner or director

Director 1 Name *

Same as above

Home address *

Postcode *

Home Telephone *

Mobile *

Date of birth *

Is there a second Director?

Yes

No

To be completed by second proprietor or director

Director 2 Name *

Same as above

Home address *

Postcode *

Home Telephone *

Date of birth *

Mobile

Your contact information

Contact 1

Same as above

Name *

Phone *

Mobile *

Email *

Contact 2

Same as above

Name *

Phone *

Mobile *

Email *

Your needs

Please complete to help us understand your business requirements

Does your business require order numbers or job references? If yes please specify *

No

Yes

Order number

Job ref

Credit limit required *

Number of employees

The main MPH branch you intend to trade with

Estimated monthly spend on materials

What we need / Trade references

Please provide names and addresses of two trade references for your business

Company name 1

Address

Postcode

Phone

Email

Company name 2

Address

Postcode

Phone

Email

Banking details

Please provide full details of your main account

Bank name *

Bank address *

Postcode *

Phone *

Account number *

Sort code *

Please add your Sort Code number as a 6 number digit without any gaps

How you heard of us

Business category

Trading terms and conditions

By submitting this application form you accept that we will complete a credit check on the information you have provided above, which may include searches through credit reference agencies, who may record the search. You also accept our trading terms and conditions which can be found here. You will automatically receive invoices and statements by email. If you wish to opt out from receiving these electronically, a small charge will be made for posting these items to you (please check with us for current rate).

If you would like to receive e-marketing updates, please indicate your preference:

Events

Exclusive discounts

Product information

We will never share your details with any other company or third parties.

Please confirm that you have attached the following documents to this application - your account cannot be opened without them: *

Copy of your trading letterhead

Copy of recent utility bill as proof of trading address (gas, electricity, landline telephone bill etc)

A member of staff has verified your address (e.g. against a driving licence)

File Upload *

Maximum upload size: 268.44MB

Please check form is completed in full to avoid delay in processing.

MPH staff name *

If not applicable type N/A

*

I acknowledge the above information and I agree to be bound by these terms, and recognise that submission of this form constitutes a signature

Name *

Job Title *

Date *