Your Details

Apply for an account...

 

If you wish to apply for a Nixon Hire account, simply enter your details in the form below. Alternatively you can download the form on the right and then either fax it back to us or post it to the address shown below. If you need any assistance please phone 0844 875 0100.

 

Your Business Details

Type of Business:


Limited Company Partnership Sole Trader
Other - Please Specify:

Customer Name:
Email address:
Company Name:
Description of Business:
Date Established:
Registered Business
Address:
City/Town::
Postcode:
Invoice Address:
Address:

City/Town::
Postcode:

Company Registration No:
VAT No:
Telephone:
Fax Number:

Monthly Credit Required:
Do you issue order numbers for hire: Yes No


Details of Hired in Plant Insurance


Insurance Company:
Insurance Broker:
Policy Number:
Contact Name:
Telephone Number:

Company Contact Details:

Accounts:
Purchasing:
Site Manager:

Please Supply two trade references

Name:
Address:

City/Town:
Post Code:
Telephone:

Name:
Address:

City/Town:
Post Code:
Telephone:

How did you hear about us?

Mail Shot Representative Newspaper Advert
Website Recommendation Yellow Pages

Please state the type of equipment you wish to hire:


I have read and agree to be bound by your Conditions of Hire

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