Trade Application Form

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Company Name(Required)

Name of Rep. (If known)

Your Details

Your Name(Required)

First Last

Position In Company(Required)

Your Phone(Required)

Your Email Address(Required)

Company Details

Type of Company(Required)

Company Name(Required)

Trading Name(Required)

Business Phone(Required)

Company Reg No.

Company VAT No.

Trading Address(Required)

Street Address Address Line 2 City County / State / Region Postal Code

Credit Application

Are you applying for a Credit Account(Required)

Yes

No

Credit accounts are not automatically applied and may be subject to credit checking. Please submit a trade reference to apply.

Trade Reference

Name of Referee(Required)

Name of Referee Business(Required)

Referee Email(Required)

Referee Phone(Required)

Referee Trading Address(Required)

Street Address Address Line 2 City County / State / Region Postal Code Country

Payment Details

Person Responsible for Payment Authorisation(Required)

Acc. Dept Phone No.(Required)

Billing Address

Same as the company Trading Address

Use an alternative Billing Address

Billing Address

Street Address Address Line 2 City County / State / Region Postal Cose Country

Please add a billing address if this is different to the companies trading address

Delivery Details

Contact Name(Required)

Full Name

Contact name for delivery arrangements

Contact Phone(Required)

Contact phone number for delivery arrangements

Delivery Instructions (For example: Opening times or special access information)

Payment Terms

Cash/cheque on delivery. Credit Accounts - 15th day of month following invoice date unless otherwise agreed in writing. We acknowledge that we are personally responsible for payment and discharge of the account in the event of non-payment by the company.

Date(Required)

Name(Required)

First Last

Signatory (Position in Company)

Signature(Required)

If you wish to set up a Direct Debit with Delitalia Ltd

Please ensure that you have submitted the Trade Application Form before proceeding to set up the Direct Debit. Your Direct Debit will be set up now, but we'll confirm the amount and let you know before future payments are taken.

Set up a direct debit with GoCardless Set up Direct Debit

Online Ordering App

Order via our app. Create an account below with your preferred password. We'll send login details once your account is ready.

Preferred Password

Maximum 10-digits. You can change your password once logged into your account.

Comments

This field is for validation purposes and should be left unchanged.

Delitalia Account Application

Next Steps: Sync an Email Add-On

Your Details

Company Details

Credit Application

Trade Reference

Payment Details

Delivery Details

Payment Terms

If you wish to set up a Direct Debit with Delitalia Ltd

Online Ordering App

Online Ordering App

Need help with your application?

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Delitalia Account Application

Next Steps: Sync an Email Add-On

Your Details

Company Details

Credit Application

Trade Reference

Payment Details

Delivery Details

Payment Terms

If you wish to set up a Direct Debit with Delitalia Ltd

Online Ordering App

Online Ordering App

Need help with your application?

Pin It on Pinterest

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