Premier Card Application

First Name

Last Name

Company Name

Phone Number

Correspondence Address Line 1

Address Line 2 (optional)

Town/City

County (if applicable)

Postcode

Email

What are main activities for your organisation?

How many staff are in your organisation?

Generally, on how many sites does your organisation operate at one time?

How far does your organisation work from base/Head Office?

Approximate amount of Building Material purchased by your organisation per month?

From time to time, we would like to contact you with details of our offers, other services and products and industry information. If you consent to us contacting you for this purpose, please tick to say how you would like us to contact you:

Which branch will you use the most?

How did you hear about us?

I've read and agree to the Terms & Conditions of the Buttles Premier Card