- New Account Application Form

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We’re updating our Terms and Conditions April 3, 2019

Thank you for being a valued Duffields customer. We want to let you know that we’ve updated our Terms and Conditions in the wake of Brexit. Please take a moment […]

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Become a local feed stockist

NAME OF APPLICANT (PERSON RESPONSIBLE FOR PAYING INVOICES)*
Prefix First Last
TRADING NAME*
ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
PHYSICAL ADDRESS (IF DIFFERENT FROM ABOVE)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
PLEASE TICK APPROPRIATE*
- LTD COMPANY
- NON-LTD COMPANY
- INDIVIDUAL
- PARTNERSHIP
COMPANY NUMBER (ONLY IF LIMITED COMPANY)*
NAMES & ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
First Last
ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
NAMES & ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
First Last
ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
NAMES & ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
First Last
ADDRESSES OF ALL PARTNERS (ONLY IF PARTNERSHIP)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DELIVERY CONTACT*
DELIVERY TEL. NUMBER*
DELIVERY E-MAIL ADDRESS*
ACCOUNTS CONTACT*
ACCOUNTS TELEPHONE NUMBER*
ACCOUNTS E-MAIL ADDRESS*
DELIVERY ADDRESS (1)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DELIVERY ADDRESS (2)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
VET NAME*
VET PHONE NUMBER*
FAX
PAYMENT TERMS
- 7 DAYS
- 14 DAYS
- 21ST OF MTH FOL. DEL.
- UPFRONT ONLY
PAYMENT METHOD*
- DIRECT DEBIT
- CARD/CASH
- BACS
- CHEQUE
BANKERS NAME AND BRANCH*
TRADE REFERENCES*
HOW DID YOU HEAR ABOUT US?*
GUARANTOR FULL NAME
First Last
GUARANTOR ADDRESS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
GUARANTOR CONTACT NUMBER
AMOUNT OF CREDIT REQUESTED
MONTHLY - MAXIMUM £
AVERAGE £
Type of stock kept?
Type of product ordered?
Average monthly required tonnage?
ACREAGE*
- OWNED
- RENTED
Are you willing to accept electronic invoices?*
- Yes
- No
Are you willing to accept marketing communications?*
- Yes
- No
Any overhead cables or height restrictions?*
Any restriction on lorry size?*
Is there a fork lift on site?*
Delivery time restrictions?*
AREA MANAGER*
OFFICE USE
Account No
Credit Limit
*
Please agree to the following Terms & Conditions
- I have read and agreed to the Terms and Conditions