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 477 2909.

Ground-Guards is a registered trademark of Greensward Engineering Co

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: 12345678910111213141516171819202122232425262728293031 JanFebMarAprMayJunJulAugSepOctNovDec 20122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912

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