Fibre Distribution New Customer and Credit Request Form

Please complete the fields below and submit. A representative from Fibre Distribution Ltd will be in touch with you as soon as possible.

Company:
Email:
Tel:
Fax:
Registered Office Address:
Invoice Address:
Accounts Contact Name:
Accounts Contact Tel:
Company Reg. No.:
Company VAT No.
Please provide the names and addresses of two trade references:
Trade Ref 1:
Trade Ref 2:
Name of Authorising Signatory:
Jobtitle of Authorising Signatory:
Date: