Inactive Customer Questionnaire

Company Name(Required)

Trading As (Only fill in If it's different)

Why Haven't We Heard From You?(Required)

Other Reasons:

Would you like to place orders with us again?(Required)

Website(Required)

Address(Required)

Billing Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Address

Shipping Address (If different from Billing)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Company House Reg No.(Required)

VAT Reg No.(Required)

Main Point Of Contact(Required)

First Last

Email(Required)

Phone(Required)

Who Invoices should be directed towards (If different from above)

First Last

Phone

Please List your Opening Hours

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