QD67 Form

(Items marked are required.)

Company name

WL Salesperson

Registration No.

VAT Reg. No.

Invoice Address 1

Invoice Address 2

Invoice Address 3

Invoice Town

Invoice County

Invoice Postcode

Invoice Telephone

Delivery Address 1

Delivery Address 2

Delivery Address 3

Delivery Town

Delivery County

Delivery Postcode

Delivery Telephone

When entering a person's name below, please include both the forename and the surname. Multiple emails can be entered if separated by a semi-colon.

Main Contact Full name

Main Contact Position

Main Contact Telephone

Main Contact Mobile

Main Contact Email

When entering a person's name below, please include both the forename and the surname. Multiple emails can be entered if separated by a semi-colon.

Other Contact 1 Full name

Other Contact 1 Position

Other Contact 1 Telephone

Other Contact 1 Mobile

Other Contact 1 Email

When entering a person's name below, please include both the forename and the surname. Multiple emails can be entered if separated by a semi-colon.

Other Contact 2 Full name

Other Contact 2 Position

Other Contact 2 Telephone

Other Contact 2 Mobile

Other Contact 2 Email

No. of Frames Wk.

No. of Teams

Alternative Supplier

Glazing

Glazed Discount (in %)

Unglazed Discount (in %)

In the next section, please specify the full name and the email address to which documents should be sent. Multiple emails can be entered if separated by a semi-colon.

Quotes recipient full name

Quotes recipient email

Order acknowledgements recipient full name

Order acknowledgements recipient email

Invoices recipient full name

Invoices recipient email

Delivery schedules recipient full name

Delivery schedules recipient email

Submit your QD67 by clicking the button below.