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New Account - Application Form

It is Company policy that when analytical work is requested for the first time, all new clients are required to settle their account in advance in pounds sterling. For subsequent work, a Purchase Order requesting an invoice on completion of the analysis may be accepted. To establish an Account in your name, please supply the following information.

If you would prefer to submit this form by post or fax, please use this PDF version.

Company Details:

Company:
Address:
(to which
invoices should
be sent)
Account Contact Name
Tel No.
Fax No.
Email
Web Address
Company Reg. No.

Bank Details:

Bank Name
Address:
(to which invoices should be sent)
Tel No.
Fax No.
Account No.
Sort Code

Credit References

Company
Address
Contact Name
Tel No.
Fax No.
Email
 
Company
Address
Contact Name
Tel No.
Fax No.
Email
  

If you have any questions please do not hesitate to contact our Accounts Manager - Albert Kitson albert.kitson@butterworth-labs.co.uk