Apply for an account

Please note – this form must be completed and returned BEFORE work is carried out if credit terms are required

New Customer Form

Contact Information


General Company Information


Accounts Payable Information


Authorisation Information


This completed form represents and warrants that:
(a) the party signing below is an authorised representative of the company
(b) that the information provided herein is complete and accurate. Any misrepresentation or fraudulent information provided will be the basis for default under this agreement.
(c) You agree that all invoices raised on this account are payable 30 days from invoice date (unless otherwise agreed).
(d) You agree to be bound by Uphire UK Ltd terms and conditions, available on request.