NEW ACCOUNT 

 Branch of an existing   A/C ?   

 No   Yes  
Company Name  
Primary Contact      Forename     Surname 
Address  
Postcode  
Country  
Telephone (inc STD)         Fax (inc STD)  
E-Mail  
Company Registration   No.   
Customer Category  Reseller   Original Equipment Manufacturer   End User*   Other

*

  End Users - your details will be forwarded to our local stockist if you are UK based.   
I would like a copy of the catalogue.
 
 Thank you for taking the time to fill in the form
 If you have any queries please call our general helpline.
 Tel  0845 456 1222 within UK or (0044) 1695 52770 from outside UK.
 You can also email us at sales@flowtech.co.uk