Fuel Card Application


I'm a CharityI'm a Corporate


About the charity

Charity Name:
Charity Number:

Business Details

Full Company Name:
Company Trading Name (if different):
Nature of business:

Business Address

Address Line 1:
Address Line 2:
Postcode:
Has the company been at this address for less than 3 years?
If yes, please give previous address:


Company Contact Details

Full Name:
Position:
Phone Number:
Fax Number:
Email Address:

Company Details

Year Established:
Vat Registration Number:
Number of Employees:
Number of Vehicles:
Number of Partners/Directors:
Company/Charity Registration Number:
Company's Trading Status:
Estimated Monthly Expenditure:

Owner 1 / Partner 1 / Director 1 Details

Full Name:
Position:

Owner 2 / Partner 2 / Director 2 Details

Full Name:
Position:

Other Shell Account(s)

Account Number 1:
Account Number 2:
Account Number 3:
Account Number 4:

Bank Details for Donation Payment

Bank Name:
Accont Number:
Sort Code:



Charity Name

Charity Name:
Charity Number:

About You

Full Name:
Position:
Phone Number:
Email Address:

Bank Details for Donation Payment

Bank Name:
Accont Number:
Sort Code: