Computer Room Installations

Purchase Order Account Application

NOTE: If you already have an account with us, please login at the login page.

Please note, Schools, Colleges, Hospitals and Government departments do not need to complete this form. Just fax or send an official order and we will then supply the goods and invoice you on our standard 30 day credit terms. Official purchase orders on headed company paper are required. These may be emailed or faxed to us on 0871 6611524.

Company Details * Required Information

Company Name:
Street Address:	*
City:	*
Post Code:	*
Country:	*
Telephone Number:	*
Fax Number:
Credit Amount Requested : �	*
Length of time in business:	*
Company Type:	*
Number of employees:	*

Credit References: Give complete Name, Address, Phone Number, and Fax Number

Reference 1:	*	Address:	*
City:	*	County:	*
Phone:	*	Fax:	*

Reference 2:	*	Address:	*
City:	*	County:	*
Phone:	*	Fax:	*

Reference 3:	*	Address:	*
City:	*	County:	*
Phone:	*	Fax:	*

Accounts Payable Contact:

Gender:	Male Female *
First Name:	*
Last Name:	*
E-Mail Address:	*
Telephone Number:	*

Options

Newsletter:

Account Password

Password:	*
Password Confirmation:	*

TERMS: Full invoice payment within 30 days of our invoice date.

If this account is refereed to a third party collection agency all associated collection cost will be paid by you, the customer.

Authorization is granted to make credit inquires with the references listed above. BY CLICKING THE SUBMIT BUTTON BELOW I HAVE READ THE ABOVE AND AGREE TO COMPLY WITH THE TERMS OF PAYMENT AND OTHER STATED CONDITIONS.