Order Contact

First Name

Telephone

Last Name

Accounts Contact (If different to order contact)

First Name

Telephone

Last Name

Name & address of all partners (where appropiate)

Years in business

Bank details

Amount requested for credit limit

Default delivery address (If different to trading address)

Agreement that the information provided is true and accurate

I verify that the information provided is true and accurate

Agreement for credit checks

I agree for Hurrell & McLean Seeds Ltd to run a credit check against the information above provided

Print name

Positon at company

Date

Thanks for providing the information, we will now start the application process.

If you would rather fill a paper copy please download the credit form attached, once complete scan and email it to - jo@hmseeds.com