Application Form

Please complete all sections of this form. We will review your application and follow up within 2–3 working days. Fields marked * are required.

Business Information

Applicant's full legal name*

Trading name (if different from above)

Principal nature of business*

Year business established

Annual turnover (£)

Contact Details

Telephone number*

Mobile number

Email address*

Website

Trading Address

Address*

City*

Postcode*

Delivery Address

Same as trading address

Delivery address

City

Postcode

Registration & Tax

VAT registration number

AWRS number (wholesalers only)

Business type*

Limited Company Details

Registered office address

City

Postcode

Company registration number

Director Details

Director 1 — full name & home address

Director 2 — full name & home address

Partner / Proprietor Details

Partner 1 — full name & home address

Partner 2 — full name & home address (if applicable)

Bank Details

Bank name

Bank address

Bank postcode

Account number

Sort code

Trade References

Please provide two trade references with whom you have traded for 2 years or more.

Reference 1

Company name

Contact name

Address

Postcode

Telephone

Reference 2

Company name

Contact name

Address

Postcode

Telephone

Credit Terms Required

Credit limit required (£)*

Per

Declaration

I/We agree that the credit facility will be on Gerrard Seel's stated terms and that adherence to this obligation is the essence of the contract between us. I/We authorise our bankers to provide a banker's opinion as to our suitability for the requested credit. We may make a search with a Credit Reference Agency, which will keep a record of that search and will share that information with other businesses. We may also make enquiries about the principal directors.

Signed by (full name)*

For and on behalf of

I confirm that the information provided is accurate and that I am authorised to submit this application on behalf of the business. *

✓

Application received

Thank you — we've received your credit application and will be in touch within 2–3 working days. If you have any questions in the meantime, please contact wines@gerrardseel.co.uk.

Contact us

We’re here to answer your questions and we're always glad to talk to you.

If a “Contact Us” form doesn’t pop your cork and you’d rather get in touch with us directly, we can be found at:

Honest Grapes t/a Gerrard Seel,
29 Melford Court,
Hardwick Grange,
Woolston,
Warrington,
WA1 4RZ

✆01925 819695 ✉ wine@gerrardseel.co.uk