McCoy's Glass Application

Full Name*

E-mail*

Have you been in contact with McCoy's Glass prior to completing this form?*

If yes was answered above, please advise us whom you dealt with?

Office Number

Cell Number*

Company Name if Registered

Company Registration Number

VAT Registration Number

Members/Director/Partners/Owners Identity Numbers*

Physical Address (Please include Postal Code)

Postal Address (Please include Postal Code)

Documents Required with Form:

CK Document

Vat Registration

Identity Document / Individual*

Identity Document / Individual (2nd person)

Identity Document / Individual (3rd person)

Is you offloading area Level?

Yes
No

Please provide us with a few pictures of your offloading bay/area?*

Glass Requirements (QTY, Product and Size)*

DISCLAIMER: This form and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. This form contains confidential information and is intended only for the individual completing. Although McCoy’s Glass has taken reasonable precautions to ensure no viruses are present in this email, McCoy’s Glass cannot accept responsibility for any loss or damage arising from the use of this form or attachments

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Online COD Application

Apply now to become a Trade Customer with McCoy's Glass

Documents Required with Form:

All COD Customers - payments must reflect in our bank account before any orders or deliveries will be made