This form is strictly to apply for a wholesale account.  If you have any questions regarding its usage please contact us first before attempting application.

BUSINESS DETAILS

BILLING ADDRESS

Check this box if Billing Address and Shipping Address are the same.

SHIPPING ADDRESS

CONTACT DETAILS

Payment Details (for your reference)

Bank Name : HSBC

Sort Code : 40 - 11 - 18

Account Number : 45162319

I confirm that all information supplied above is correct and accurate to apply for a VehicleBlinds Wholesale Account. Please also sign your initials in the box below.