Required information is denoted with a * |
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Name and contact details |
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*Business/Buying Group Name: |
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*Contact name: |
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*Telephone: |
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*Email address: |
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Accounts Dept: |
- tick if contact/phone/email is as above
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*Accounts Phone: |
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*Accounts contact: |
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*Accounts Email: |
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Delivery Address: |
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Billing Address: |
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*Address 1: |
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*Address 1: |
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*Address 2: |
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*Address 2: |
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*Address 3: |
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*Address 3: |
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*Address 4: |
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*Address 4: |
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*Postcode: |
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*Postcode: |
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*Country: |
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*Country: |
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*Proof of Trade:
*e.g. Web address/Social Media
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*Type of business: |
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*Upload Proof:
*(.pdf,.png,.jpg,.jpeg,.gif only)
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*Business status: |
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*If other, please specify: |
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*How you found us? |
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*Company reg no: |
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*If other, please specify: |
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*Company VAT no: |
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*Prefer shopping by: |
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*Prefer paying by: |
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Additional information |
If you are a fellow Co-operative, please tick here: |
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If you are interested in our mixing or own label service, please tick here: |
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If you require a paper copy of our catalogue please tick here: |
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Sign up for the Essential monthly e-bulletin: |
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Important - deliveries are made in large vehicles so please provide information regarding any delivery or access restrictions,
e.g street access for lorries, parking restrictions, opening/closing times for your premises.
Also please tell us a bit about your business and any other relevant information:
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Terms & Conditions |
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I agree with the above T&Cs |
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