Apply for Credit

Personal Information

Please enter the name, email address and position within the company of the person completing this application.

Any questions relating to this application will be sent to this person, plus confirmation that the account has been approved.

Applicant Name*

Applicant Email*

Position*

Your company name, registered address and company registration number should match those registered at companies house.

If your company is part of a larger company or group, please provide the holding company address.

If your company is exempt from paying VAT you will be asked to provide proof of this when your application is approved.

Company Name*

Registered Business
Address*

Invoice Address*

Phone Number*

Company Reg No.*

VAT No.

VAT Exempt?

Years Trading*

Holding Company Address*

Trade Reference 1*

Trade Reference 2*

Credit Limit Required*

Accounts Contact*

Accounts Email*

Invoice Email*

Payment By

Please let us know who at Connectix referred you to the credit application form.

Current Point of Contact at Connectix

How did you find out about Connectix

I agree to abide by the Connectix Limited terms and conditions of sale and pay approved invoices 30 days from the date of invoice.