Customer Account Application Form

Please complete the form below if you would like to become a customer of West Mercia Supplies. Please note that in general WMS can only supply the public sector, educational establishments and associated bodies. For security reasons WMS can not deliver to private addresses.

If you are an existing customer and would like access to the members section of this website please click here. You do not need to complete this form as we already have this data.

Organisation Name:
 
Delivery Address:
 
City / Town County
Postcode
  
Invoice Name:
Invoice Address:
 
City / Town County
Postcode
 
Contact Name
Telephone Number
Fax Number
E-mail Address
Password to Access Website
Please Confirm Password
 
Is the Organisation:  
A. Local Authority Owned  Yes  No
B. Intending to operate for a profit?  Yes  No
C. A member of the Preschool Learning Alliance?  Yes  No
D. A Registered Charity  Yes  No
If you answered Yes to D, what is your registration No
Please give a brief description of your organisation:
   
Deliveries  
Are you open for deliveries Monday to Friday, 8.30am to 4pm?  Yes  No
Please give further details of your opening times eg. Closed Wednesdays:
Are you closed during the school holidays?  Yes  No
Is access to your property difficult? Would a lorry or a van be more suitable?  Van  Lorry
 
West Mercia Supplies
Telephone
01743 241130
Holsworth Park, Oxon Business Park,
Bicton Heath, Shrewsbury SY3 5HJ