Account Application Form

To apply for a trade account, download and complete the application form using the button below.

On Completing The Form

You can use the contact form on the right to submit the application form, or you can fax the form back to us on:

Fax: 024 7636 4747

You can also post the completed application form back to us on the following address:
Midland Vehicle Components Ltd.
2 Oban Road
Longford, Coventry