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Your company details

Company:
Address:
Type of Business:
Nature of Business:
Telephone:
Fax:
Email:
First Trading Date:
Date of Registration:
Registration Number:

Please List at Least Two Company Officers (or Principal Partners in case of Partnership)

	Name:	Title:	Address:
1.

	Name:	Title:	Address:
2.

	Name:	Title:	Address:
3.

Your Bank Details

Bank Name & Address:
Account Number:		Sort code:		Contact:

Please supply the names of two unconnected companies who we may contact for a trade reference.

1.
Company:
Address:
Email:

2.
Company:
Address:
Email:

Amount Of Credit Requested: GBP
In consideration of Kangaroo International Express (hereinafter referred to as 'The Company') granting credit to the customer, the customer affirms & agrees to The Company's terms and conditions, a copy of which are available upon request.