CALL US NOW ON +44 (0)1494 838 389

Cash Account Application

Cash Account Application

Your Details

Please complete all fields marked with a *.

*Trade Name (required)

*Address 1 (required)

Address 2

*Town / City (required)

County / State

*Postcode / Zip (required)

Country

*Phone Number (required)

Fax Number

Web Address

VAT No

Delivery Address

Please supply details of main delivery address, if different to above


Contact Information

In order to provide you with the best possible service, we would be grateful if you could provide us with the following information:

Key Contact Name

Key Contact Email

Purchaser

Purchaser Name

Purchaser Phone No

Purchaser Email


Accounts Payable

Accounts Name

Accounts Phone

Accounts Email

Invoice Email

Opening Hours

Best Time to Contact


Order Acknowledgement Email

*Where would you like your order acknowledgement email to go to?


Where did you hear about us?

For items marked with a * please specify which one in the box below.


*Other

Have you already had contact with ProUV Lamps?


Pro UV Lamps Contact Name


Terms & Conditions

Account Requested By (required)

Position in Company (required)


*Do you wish to receive marketing emails from Pro UV Lamps Ltd. on occasion.
We will keep all your details safe and will not pass them on.

No Thank You.Yes Please.

Tick here to accept our Terms and Conditions of Sale

Please prove that you're human. By typing this "captcha" in the box below.