1
Thank you for requesting a Trade Account with
LASGO WORLDWIDE MEDIA
Please complete the following Trade Account
Application Form and return by post, email or fax to:
Account Applications
Unit 1 Falcon Park Industrial Estate
Neasden Lane, Neasden
London NW10 1RZ
United Kingdom
Telephone: +44 (0)20 8459 8800
Facsimile: +44 (0) 20 8452 7491
opening up an Account
1. Please ensure that all sections are completed in full before returning the forms to the above address.
You will be notified by email upon receipt of your account application form being received in our offices.
ALL DETAILS SUPPLIED WILL BE TREATED IN THE STRICTEST CONFIDENCE
2. The processing of application forms may take up to 48 hours to complete. After all necessary checks
have been performed, we will advise you if we are able to offer you credit terms, or if the only terms we
can offer are prepaid. If the only terms we can offer you are prepaid, then you can choose to make
payment by bank transfer or credit card.
3. Once your account is set-up, one of our Account Managers will contact you to discuss your company
requirements. Your account will be activated as soon as your first order is submitted.
Help or Questions
Please contact us on + 44 (0)208 459 8800 or email [email protected]
ACCOUNT APPLICATION FORM
PLEASE RETURN TO: Account Applications, Lasgo Worldwide Media, Unit1 Falcon Park Ind Est. Neasden Lane, Neasden, NW10 1RZ
Tel: +44 (0)20 8459 8800 Fax: +44 (0)20 8452 7491 Email: d.w[email protected]
[PLEASE USE BLOCK CAPITALS AND COMPLETE FULLY]
COMPANY INFORMATION
Full Company Name:
Trading Name (if different from above):
Vat No:
Web Address:
Invoice Address:
Post Code:
Tel No:
Fax No:
Email:
Delivery Address:
Post Code:
Tel No:
Fax No:
Email:
Contact Buying:
Email Address:
Contact Accounts:
Email Address:
LIMITED COMPANY DETAILS
Company Registration Number:
Registered Office Address:
Post Code: Tel No: Email:
Date of Incorporation: / /
TYPE OF BUSINESS
Type of Business: Wholesaler E.Commerce Partnership Sole Trader
Retailer Distributor
Product of Interest: DVD / Blu-ray Music CD Vinyl Merchandise
Type of Interest:
Catalogue Campaigns Overstocks/Deals
BANK DETAILS
Bank Name:
Bank Address:
Post Code: Tel No:
Account Number: Sort Code:
Type of Account: Account held since:
How did you hear about Lasgo :
Cons. Electronics Other, (specify):
B2B Login
Buyers Name: Buyers Email Address:
If you require a login to our B2B website, please complete the details above.
EORI No:
Type of Interest:
ACCOUNT APPLICATION FORM
3
CONNECTION WITH OTHER COMPANIES
State any associated companies:
Have the directors/proprietors had any previous dealings with Lasgo Worldwide (please give details):
DETAILS OF ALL DIRECTORS, PROPRIETORS, PARTNERS (please add extra sheets if required)
1. Name 2. Name
3. Name 4. Name
TRADE REFERENCES (please list two Main suppliers)
1. Company Name:
Address:
Post code: Tel No: Email: Contact:
2. Company Name:
Address:
Post code: Tel No: Email: Contact:
DATA PROTECTION ACT
Where I/we provide you with personal data, I/we understand that the data will be held securely in confidence and processed for the purposes of carrying
out your supply and distribution business and associated activities. In considering my/our application, I/we accept that you may consult with and disclose
the data to credit reference agencies, banks, credit insurers and other responsible organisations outside your business and located anywhere in the
world that you have nominated (‘third parties”), and that such third parties may process the data. I/we understand that under the Data Protection Act
1998 I/we have a right to know what data you hold on me/us if I/we apply to you in writing
DECLARATION
I/We confirm that the information given in this Account Application Form is in all respects true and accurate. I/We confirm that I/we have read and
understood your terms and conditions of sale/business and I/we unconditionally accept that those terms and conditions shall be the only ones that apply
to all sale contracts, which I/we may conclude with you. . I/we understand that Lasgo Worldwide may carry out regular checks to ensure credit
worthiness is maintained.
By Signing this application, you agree to our Terms and conditions of Sale supplied herewith
Signed: Name: Date:
Company Stamp
Position:
Company stamp
TYPE OF ACCOUNT REQUIRED
Credit Account: Prepaid Account:
COMPANY DATA
Annual Turnover: No of Employees: