Account Application Form

Please ensure all fields in this form are completed, in order for us to efficiently process your account.

Once the fully completed form is submitted, a copy will be emailed to the main contact email address. You also have the option to print a copy of the form at the end.

If you have any queries regarding the completion of this form, please direct them to your new business manager, or call 020 7553 7900.

Part A – Customer Details

Supply Agreement Between: Freshground, Synergy House, NR9 5SP. VAT no: GB 224 and;

Part B - Customer Direct Debit Details

Instruction to your Bank or Building Society to pay by Direct Debit. The Fresh Ground Coffee Service. Service User Number: 260650.

Please pay The Fresh Ground Coffee Service Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with The Fresh Ground Coffee Service and, if so, details will be passed electronically to my Bank/Building Society.

Direct Debit Guarantee

This Guarantee is offered by all Banks and Building Societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit, The Fresh Ground Coffee Service will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request The Fresh Ground Coffee Service to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit, by The Fresh Ground Coffee Service or your Bank or Building Society, you are entitled to a full and immediate refund of the amount paid from your Bank or Building Society. If you receive a refund you are not entitled to, you must pay it back when The Fresh Ground Coffee Service asks you to. You can cancel a Direct Debit at any time by simply contacting your Bank or Building Society. Written confirmation may be required. Please also notify us. All fields are mandatory.

Print a copy