Basil Bush Wholesale

Company Name *

Trading Name

Delivery Address *

Telephone *

Email Address *

Company Website *

Line of Business *

Type of Company *

Date Registered/Started Trading *

VAT Number (if applicable)

Company Number *

Company Registered AddressPrivate Address of Partners/Sole Trader *

Directors Name(s)Names of Partners/Sole Trader *

Mobile Number(s)Mobile Number(s) *

Opening Times *

Special Delivery Instructions

Names of Employees authorised to place orders *

Proof of Trading
• Business, shop or market lease
• A working website
• Company number registered with companies house (which must match the information given on page 1)

Proof of Address
• A Utility bill, Bank statement, etc
(We do not accept invoices from other companies as proof)

* We send out promotional flyers via email. These include discounts and special offers. If you would like to be included on our mailing list, please select 'Opt in' below and confirm the email address you'd prefer we send our offers to.

Where did you hear about us? *

Your Name *

Position in Company *

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Wholesale Account Application