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 — now please set up a Direct Debit mandate. This will make your billing fast, simple and reliable.

We 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