Mileta Signs - Distributor Application Form

Where to find our nearest wholesaler

Please complete the form to apply for a Credit Accounts:

Fields marked * must be completed to allow us to contact you.

Applicants Details:		Contact Names:
Company:*		Owner/Director: (required)
Address:*		Sales Manager:
Telephone:*		Purchasing Manager:
Fax:		Company Secretary:
Email:*		Accounts:
Mobile:		VAT No:
www:		Company No:

Brief description of business and type of premises:
(Shop, Office, Warehouse etc)

Bank References:

Bank Name:
Banks Address:
Telephone:
Account Name:
Account No:
Sort Code:

Trade References:		Trade References:
Supplier Name:		Supplier Name:
Supplier Address:		Supplier Address:
Contact Name:		Contact Name:
Telephone Number:		Telephone Number:

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