Credit Application Form

How to become a PureTech trade account holder

It couldn't be easier to become a PureTech trade account holder.

But please note, this form is for TRADE CUSTOMERS ONLY.

Simply fill out the form below and a member of our team will contact you by the following working day. Once your application has been approved, we'll then send you a confirmation email containing your website log-in details.

Why you should join

Exclusive deals, discounts and offers for members
Best advice from your dedicated account manager
Priority technical support from our experienced team
Competitively priced products with no compromise on quality
Huge range of products in stock and ready for next day delivery

Customer Details

Company Name

Trading Name (if different)

Address

Postcode

Company Registration Number

VAT Number

Telephone

Registered Office (if different from above)

Address

Postcode

Telephone

Type of Company

Type of Company (please tick as appropriate)

Limited Company

Public Limited Company

Partnership

Sole Trader

Parent Company Type

Trade References

Name

Telephone

Address

Postcode

Name

Telephone

Address

Postcode

Details of Directors/Partners/Sole Proprietor

Name

Telephone

Address

Postcode

Mobile

DOB

Name

Telephone

Address

Postcode

Mobile

DOB

Credit

Credit Limit Required (Min £5K)

Terms & Conditions and Privacy Policy

This application is for a 30 day EOMFI credit account and is subject to status. Please tick to agree to our Terms & Conditions of Sale and our Privacy Policy.