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Please complete the following registration form in as much detail as you can so that we can provide a better profile of the solution we can offer.

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Company Name
Trading Style
Address 1
Address 2
Address 3
Town
County
Postcode
Country
Number of Trading Outlets
Registered Office (if different to above)
Address 1
Address 2
Town
County
Postcode
Country
Company Reg. No.
VAT Number
Established Year
Company Turnover ex VAT £
Contact Details
Contact Name	Title	Forename	Surname

Position of Contact
Email
Telephone
Fax
Maintenance
Who currently carries out your maintenance?
Do ou have consumer finance?		Yes No
Select finance company
Finance company name (if not listed above)
Consumer credit license number
CCL Categories
Merchant services (we offer preferential merchant services rates)
Do you accept credit cards?		Yes No
Credit Card Company Name
Turnover on Credit Cards		Ave transaction value
Turnover on Debit Cards		Ave transaction value
Current Credit Card Service Charge
Current Debit Card Service Charge
Invoice discounting (we offer preferential invoice discounting and factoring rates)
Do you use invoice discounting?		Yes No
Invoice Discounting Company
Other
How many desktop PCs do you sell a month?
How many Laptops do you sell a month?
Brands of Desktops sold
Brands of Laptops sold
References (required for merchant services and invoice discounting)
Names and home addresses of all directors / partners / proprieters
Bank Name
Bank Address
Bank Account Number
Bank Sort Code
Login details (please enter details that you will use to login to the site at a later date)
User Name
Password

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