Welcome to Wilts - The UK's largest independent electrical wholesaler
info@wilts.co.uk

My Account - Account Application Form

To apply for a Wilts account, please fill in and submit the form below or download a PDF version here
 
Name of Company / Firm / Organisation:
Date Established:
VAT Number:
Company Registration No.
Statement Address
Sales Contact:
Telephone:
Fax:
Mobile:
Email:
Accounts Contact:
Telephone:
Fax:
Mobile:
Email:
For Sole Proprietors / Partnerships only
Name: (Senior Partner / Associates)
Address
Date of Birth:
Name: (Senior Partner / Associates)
Address
Date of Birth:
Invoice Details:
If address, please give details if different from statement
Trade Ref. Name:
Trade Ref. Address:
Telephone:
Trade Ref. Name:
Trade Ref. Address:
Telephone:
Company Details
Local Branch:
Monthly Credit Limit Required:
If other, please state limit required:
VAT Exempt?
If yes, please attach certificate:
Your Industry Type / Category:
If other, please state industry type / category:
Type/make of major products:
If other, please state type/make of major products:
Other Wholesale Suppliers:
If other, please state other wholesale suppliers:
Employees:
If other, please your number of employees:
Aprox Annual Spend with Wholesalers:
If other, please state your annual spend:
Declaration and Data Protection Notice
I / we confirm that the information given in this (Credit Account Application Form) is in all respects true and accurate. I/we confirm that I/we have read and understood your terms and conditions of (Sales / Business) and I / we unconditionally accept that those terms and conditions shall be the only ones that apply to all sale contracts which I / we may conclude with you.
 
Data Protection Act 1998 Notice Words shown in italics are defined in the Data Protection Act 1998 ("the Act")
Where I / we provide you with personal data, I / we understand that the data will be held securely in confidence and procesed for the purpose of carrying out your wholesaling supply business and associated activities. In considering my / our application, I / we accept that you may consult with and disclose the data to credit reference agencies, bank, credit insurers and other responsible organisations outside your business that you have nominated ("third parties") and that such third parties may process the data. I / we understand that Under the Act I / we have a right to know what data you hold on me / us if I / we apply to you in writing and pay the applicable fee.
Do you accept these terms & conditions?
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