Please Complete All Sections in BLOCK CAPITALS and Return to the Sales Department

Bertram Books

1 Broadland Business Park

Norwich, Norfolk, NR7 0WF

Website: www.bertrams.com

Telephone: 01603 648486

Fax: 01603 648109

NON CREDIT APPLICATION FORM E-mail:

Please complete all sections in BLOCK CAPITALS and return to the Sales Department

Please note ALL pages of this form must be returned regardless of whether they are completed or not.

Section 1: About your Business

Name of Business:
Invoice Address:
Postcode*:
Store Tel: / Store Fax:
Email Address:
Statement Email:
(if different)
VAT Registered? Y/N / VAT No. (if applicable):
Company Registration No. (if applicable) / SAN No: (if applicable)
Applicant’s Contact Details / Full Name:
Tel: / Fax:
Email:
Additional Contact Names: / Contact Name: / Telephone / email / Position:
Contact Name: / Telephone / email / Position:
Delivery Address (if different to invoice address):
Postcode*:
Tel: / Fax:
Email Address:
Shop Opening Times
Special Delivery Instructions
Age of Business: / Years / Months
Trading Nature: / Is your business a retail outlet open to the general public? / Yes: o No: o
Nature of your business: / Bookshop: o Internet: o / Other:______

* It is essential to provide your postcode

Section 2: Important Notes and Declaration

Important notes:

1.  Before signing below, you should carefully read our Terms and Conditions of Business with our Customers.

2.  We reserve the right to terminate supplies if any of the details given on this form are false.

3.  All supplies are made on a firm sale basis

Declaration:

1.  I have read, understood and agree to be bound by Bertram Trading Limited’s Terms and Conditions of Business (a copy of which has been provided to me).

2.  I confirm, warrant and certify that I have the requisite authority to bind all persons named in this application, upon which such Terms and Conditions of Business shall constitute legal, valid, binding and enforceable obligations.

3.  I confirm that I am a bona fide trading company and wish to purchase supplies for sale to the general public rather than for any personal use.

Signature:
Name:
Date of Birth: / Date:

If you are operating as a Partnership or Limited Company, all Partners / Directors must also sign to confirm their agreement to the terms stated above.

Signature:
Name:
Date of Birth: / Date:
Signature:
Name:
Date of Birth: / Date:
Signature:
Name:
Date of Birth: / Date:

For Bertrams use only:

Date:
Auth:

Bertram Trading Ltd t/a Bertram Books. Incorporated in England No. 6849888; Reg. Office: Rowan House, Cherry Orchard North, Kembrey Park, Swindon, Wiltshire, SN2 8UH Page 1 of 2