Xclusive Cars | Maidenhead Chauffer | Executive Travel Maidenhead

Company Name

Name to appear on your Account*

Business Sector*

Registration No.

No. of Years Trading

Monthly Spend

Address Line 1*

Address Line 2

Town*

Postcode*

Telephone No.*

Fax No.

Contact Name*

Email*

Telephone No.

Fax No.

Invoice Address

Tick box if same as Trading details above

Line 1 *

Line 2

Town*

Postcode*

Telephone No*

Fax No

Electronic invoices email*

Payments Contact

Tick box if same as Contact details above

Name*

Email*

Telephone No*

Fax No*

Payment Method

Direct Debit

Credit/Debit/Corprate Purchasing Card

BACS/CHAPS

Cheque

Do you require references to be taken at the

Department

Time of Booking?

Reference

Please state the format

Caller Name

Example Format

Existing Customer?

Yes

No

Regular Pick-Up Address

Tick box if same as Trading details above

Line1*

Line2

Town*

Postcode*

Where did you hear about Us?

Chamber of Commerce

Internet search result

Sales contact

Previously Used

Terms and Conditions *

I HAVE READ AND ACCEPT BOTH THE TERMS & CONDITIONS AND THE DISCLAIMER FORM.

X Clusive Cars

I WISH TO RECEIVE INFORMATION ABOUT X Clusive Cars.