Poultex Customer Application

Customer Application

Thank you for choosing to work with Poultex.
Your personal details ensure each communication between you and Poultex customers is targeted and specific. Poultex guarantees not to disclose your information to any third party.
The information you provide is used by Poultex to help suppliers find you as a potential customer. This ensures the product offers you receive from Poultex are relevant.
Application is free of charge.

Your Details

Company Details

Title
First Name*
Surname*
Position in Company
Telephone Number*	Please include full country dialling code
Mobile/Cell Number*	Please include full country dialling code
Email Address*
Skype Address
Preferred Communication
User Details
Username*
Password*
Confirm Password*

Company Name*
Trading Address*
Town/City*
County/State*
Postcode/Zip Code*
Country*
Website
Company Type
Company Nature
Suppliers are paid to Poultex standard terms. Do you require Poultex to arrange a credit facility with you company? Yes No If yes, please complete the green boxes below.