Company Member Application

Company Application Form

First Name*

Last Name*

Registered Company Name*

Registered Company Address*

Registered Company Town / City*

Registered Company Postcode*

UK Company Number

VAT Number

Website

Trading Company Name

Trading Company Address

Trading Company City

Trading Company Postal Code

Phone

Primary Name

Primary Email

Primary Job Title

Primary Mobile

Secondary Name

Secondary Email

Secondary Job Title

Secondary Mobile

Accounts Name

Accounts Email

Accounts Job Title

Accounts Mobile

Gross Turnover Dates 1 (e.g FEB 2017 - JAN 2018)

Gross Turnover Value 1

Gross Turnover Dates 2 (e.g FEB 2017 - JAN 2018)

Gross Turnover Value 2

Gross Turnover Dates 3 (e.g FEB 2017 - JAN 2018)

Gross Turnover Value 3

No of Employees

Main Category*

-None- Manufacturer Retailer Wholesaler Sourcing Brand Designer Bespoke maker Components Tannery Business support Education Agent / distributor Remedial / repairer Associated product Other (please specify)

Main Category Other

Additional Areas

-None- Manufacturer Retailer Wholesaler Sourcing Brand Designer Bespoke maker Components Tannery Business support Education Agent / distributor Remedial / repairer Associated product Other (please specify)

Additional Areas Other

Footwear Category Mens

-None- Casual Dress Slippers Sport Sandals

Footwear Category Womens

-None- Casual Dress Slippers Sport Sandals

Footwear Category Other

-None- Bespoke Childrens Cleaning & Accessories Comfort Consultant Dance Educator Emerging Designer Graduate Insoles Orthopedic & Medical Outdoors Safety / work Technical specialist Testing

Brands Owned

Key Market

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