Application Form
Company Information
Registered Trading Name
*
Company Website
Main Telephone Number
*
VAT Details
VAT Registration Number
Address Line 1
Address Line 2
Address Line 3
Postcode
If you are not registered for VAT, please enter 'N/A'. Please be aware that you cannot use the Packnet billing suite to invoice your end users if you are not VAT registered as a business.
Proprietor's Details
Name
*
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Been at address less than 3 years?
*
Yes
No
Previous Address Details
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Trading Address Details
Same as Proprietor's Address
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Invoice Address Details
Address Line 1
Address Line 2
Address Line 3
Postcode
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.
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privacy policy
.
Contact Information
Contact Name
*
Contact Position
*
Contact Email
*
Please enter a valid email address as you will need to confirm this later.
Contact Telephone Number
*
Same as main telephone number?
Accounts Contact Name
*
Account Contact Position
Accounts Contact Email
*
Invoices will be mailed directly to this mail address
Accounts Contact Tel Number
*
Contact Preferences
Newsletter and Marketing Contact Email
*
The preferred individual or group contact in your company to receive newsletters, marketing and email offers from Pack-Net.
Status and Maintenance Contact Email
*
The preferred individual or group contact in your company to receive status updates and maintenance window notifications.
Trade References
Trade Reference 1
Company Name
*
Contact Name
*
Telephone Number
*
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Trade Reference 2
Company Name
*
Contact Name
*
Telephone Number
*
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Bank Details
Bank/Building Society Name
*
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*
Names(s) of Account Holder
*
Sort Code
*
Account Number
*
If the account number is only 7 digits long please add a 0 in front of it.
Direct Debit Mandate
Name(s) of Account Holder(s)
*
Account Number
*
Sort Code
*
Email
*
Bank/Building Society Name
*
Address Line 1
*
Address Line 2
Address Line 3
Postcode
*