Customer Contact Form
Kindly use this form to fill your details in as accurately as possible
Company Name *
Address Line 1*
Address Line 2
Preferred branch? * Select your answerBradford Cash & CarryBradford delivery serviceLeeds Cash & CarryBolton Cash & CarryBolton delivery serviceSheffield Cash & CarrySheffield Delivery service.Birmingham Click/Call & CollectBirmingham Delivery ServiceICS wholesale.
City*
Post Code*
County
Contact Name*
Shop Number*
Mobile Phone*
Email Address*
Add Another Contact Name? Select your answerYesNo
Contact Name
Add another Email Address? Select your answerYesNo
Email Address 2
Add another Mobile Number? Select your answerYesNo
Mobile Phone 2
Name of person responsible for payment*
Direct phone number
Direct Email Address
Preferred method of payment* CashOnline transferCard machine (with driver)
File upload (jpg, png, pdf allowed | 5mb max upload limit) Please upload your company reg
Please upload Id proof
Please upload company address proof (utility bill, bank statement etc )
Upload image of front of store
Upload image of delivery entry point
