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

Applicant Name*

Applicant Email*

Position*

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

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

Company Name*

Registered Business
Address*

Invoice Address*

Phone Number*

Fax Number*

Company Reg No.*

VAT No.*

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 Connectic Limited terms and conditions of slae and pay approved invoices 30 days from the date of invoice.