CJ Love :: Membership Form

Membership Form

To become a customer of CJ Love, please complete the below form, if you would like to set up an account please click here for the account set up form. Once you have completed the form we will be in touch to confirm the set up.

Business Name

Contact Name

Buying

Accounts

Business Address

Postcode

Email address

Contact

Fax No

Shop tel

Home tel

Mobile

Company Status

How long has business been trading?

Sole trader, partnership or Ltd Co?

Full name and residential address of sole trader, partner or director(this must be completed)

Name

Address

Signature

I/We hereby apply for a credit account and agree for payment to be taken every Monday, as per statement, using the credit/debit card listed below (please supply card details at time of application)

Date

Name

Position/job Title

Membership Form

The Team

Flower Guide

History

Account Set up