Trade Account Application Form

    • New Account Details:
      Business Name:*
      Vat No:(optional)
      Company Registration No:*
    • Invoice Address:
      Address Line 1:*

      Address Line 2:*

      Address Line 3:(optional)

      City:*

      Postcode:*

      Tel:*

      Delivery Address: (if different)

      Address Line 1:

      Address Line 2:

      Address Line 3:

      City:

      Postcode:

      Tel:

    • Accounts Contact:
      Name:*

      Surname:*

      Email:*

      Direct Line Tel:*
    • Buyers Contact:
      Name:*

      Surname:*

      Email:*

      Direct Line Tel:*
    • References:
      Bankers:*


      Banker Email Address:*

      Trade:*


      Trade Email Address:*

    • Additional Information:
      Customer Web Address:(optional)
      How long in business?:*
      Sector?:*


    • Privacy Preferences:


      Our Privacy Policy gives full detail to the use of your data.

      Lixall Hygiene Services & Workwear Ltd

      First order requirement: Invoiced on a Proforma basis
      PLEASE NOTE OUR TERMS ARE 30 DAYS FROM MONTH END ANY ACCOUNTS EXCEEDING THESE TERMS WILL BE HELD ON CREDIT STOP

      * Denotes required fields

      Type the characters seen in the image below:
      captcha