New Client Registration Form

To apply for a credit account with us, please complete the form below.

If you experience any issues completing this form please call us on 01279 810 100.

Registration Form

Company Name *

Company Registration No. *

Registered Office Address *

Registered Post Code *

VAT Registration No. *

Year of Incorporation *

Nature of Business *

Company Telephone *

Company Email *

Managing Agent Name *

Company Registration No. *

Managing Agent Address *

Managing Agent Post Code *

Property Manager Name *

Property Manager Telephone *

Property Manager Email *

Finance/Accounts Contact Name *

Finance/Accounts Telephone *

Finance/Accounts Email *

Billing Preference *

Confirmation *

Choice 1 *

I confirm I am authorised to complete this form on behalf of the applicant applying for a credit account.

By confirming, I agree to abide by the terms and conditions set out by DMG Delta Ltd.

I understand that payment terms are 14 days from the date of invoice.

Full Name *

Position *

Date *

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