Account Application

Please note, fields marked with a (*) are mandatory.

Company Details








Account Contact








Finance Details







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Trade References

Reference 1







Reference 2







Nature of Business









Declaration and Data Protection Notice

I/We confirm that the information given in this (Credit Account Application Form) is in all respects true and accurate. I/We confirm that I/we have read and understood your terms and conditions of (sale/business) and I/we unconditionally accept that those terms and conditions shall be the only ones that apply to all sale contracts which I/we may conclude with you.

Data Protection Act 1998 Notice

Words shown in italics are defined in the Data Protection Act 1998 ("the Act").

Where I/we provide you with personal data ("data"), I/we understand that the data will be held securely in confidence and processed for the purpose of carrying out your supply of construction products and associated activities ("Activities"). In considering my/our application, I/we accept that you may consult with and disclose the data to credit reference agencies, banks, credit insurers and other responsible organisations outside your business that you have nominated ("third parties"), and that such third parties may process the data. I/we understand that under the Act I/we have a right to know what data you hold on me/us if I/we apply to you in writing and pay the applicable fee.

I/we agree that you may use the data to contact me/us with details of other products and services. Unless I/we have written to you objecting to you using the data for such purpose or I/we have not ticked the box below, I/we agree that you may contact me/us by post, telephone, fax, e-mail, via the internet, or other communication means.

I/we object to you using the data for direct marketing purposes

How Did You Hear About Kem Edwards?








I have read and understood and accept the Terms and Conditions of Sale

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