B Rourke & Co Ltd

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Your Order:
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£10.72

FINGER PLATE (BRASS)
£17.72

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IMPORTANT NOTE: THIS APPLICATION FORM IS FOR CUSTOMERS TO APPLY TO BROWSE OUR TRADE PRODUCTS, IT DOES NOT CONSTITUTE A CREDIT AGREEMENT WITH B ROURKE & CO LTD
FOR FURTHER INFORMATION PLEASE CONTACT JANE.GIBBONS@ROURKES.CO.UK

If you have a specific enquiry please click here we will be happy to assist you.

*BUSINESS DETAILS - required**
Are you an existing Customer	Yes No
company name*		Account No (if known)
invoice address*		tel no*
		fax no

postcode*		e-mail*
town/city*		contact name*
county/province*		nature of business

COMPANY DETAILS
how long has this company been trading under this name		company registration number (if applicable)
if less than 2 years please state previous business name and address:		registered office address:
No of Staff Employed

NAME & ADDRESS OF TWO TRADE REFERENCES WITH WHOM YOU HAVE A CREDIT ACCOUNT
name		name
address		address
postcode		postcode
Telephone		Telephone

additional comments
I hereby confirm that to the best of my knowledge the information I am submitting is accurate please note: information received is treated in the strictest confidence

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B Rourke & Co Ltd Registered Office:- Vulcan Works, Accrington Rd, Burnley Lancs, BB11 5QD Phone: 01282 422841 Fax: 01282 450043 / 458901
A Company limited by guarantee. Registered in England No 1151730. VAT No GB175 4072 62