Name of my business:__________________________________________________________

Address/registered address of my business:_________________________________________

__________________________________________________Post code__________________

Telephone:__________________    Mobile:   ______________Fax:_______________________

Email:_____________@____________________________Website:_____________________

Type of business: ________________________________How long established:____________

Delivery address (if different) ____________________________

___________________________________________________

Telephone:__________________________Mobile________________Fax________________

Name(s) of proprietor(s)/director(s):_______________________________________________

Address(es):_________________________________________________________________

___________________________________________________________________________

I enclose evidence of relevant business activity e.g. copy of advertisement, Yellow Pages entry,
printed material, invoices etc.

My present upholstery/soft furnishing suppliers are:___________________________________

Signed:_______________________________________Date:__________________________