Membership Application form - DOC

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					                                                     Membership Application form

Section One: Application Form

Company or business name _____________                       Number of employees _________________
                                                             Number of installation teams _______________
____________________________________
Trading address                                              Is your company/business registered for VAT? YES/NO
___________________________________                          If yes please supply number
___________________________________

_______ ____________         Postcode                      Dose your company/business possess
                                                           Public liability insurance up to 5,000,000       YES/NO

                                                            If yes supply copy certificate
Registered office address (if different from above)

______________________________________                     Dose your company/business possess                 YES/NO
                                                           Employers liability insurance
______________________________________
                                                           If yes supply copy certificate
__________________                      Postcode

Tel   ______________________________

Mobile _____________________________                       Full names of directors/owners _______________________

Email address________________________                       _________________________________________________

Web site____________________________                        Address __________________________________________

Date Company /business established ----/-----/----- __________________________________________________

Company registration                                       _______________________Postcode
Number if applicable    -------------------------------




Names and addresses of any company or business that any of the above named directors/owners has been, or
is Currently associated with jointly or solely, as owner, director, partner or proprietor

Name of Director: ___________________ _______                    Name of Director_____________________________

Name of Company _________________________                        Name of Company____________________________

Address    _________________________________                     Address_____________________________________

__________________________________________                       ___________________________________________

____________________ Postcode                                      __________________________           Postcode
                                         Membership Application form


Please provide details of any court or county court judgements Please provide the details of any trade Links
(Including bankruptcy) made or currently pending against any      or societies of which the company or
business is of the above named directors or companies;                         a member;

Director _______________________________________             __________________________________________

Company Details ________________________________             __________________________________________

______________________________________________               ___________________________________________

Please indicate in boxes below the area of business, which you presently work :( Brief description)
Civil Engineering
Housing Development
Building and Maintenance
Landscape and driveway



Section Two: Trade Supply References

Please supply the contact details of two trade references e.g. Suppliers/plant hire
companies

Name
____________________________________________________________________
_____________________

Address _______________________________________________________ ____
Postcode _________

Name
____________________________________________________________________
____________________

Address
______________________________________________________________
Postcode _________
Section Three: 3 Client References

Please supply the contact detail of 3 clients whom you have completed contracts for
in last 6 months

Name
___________________________________________________Tel_______________

Address
___________________________________________________Postcode__________

Contact________________



Name_______________________________________________Tel__________

Address
___________________________________________________Postcode__________

Contact_______________



Name ____________________________________________                    Tel___________

Address
___________________________________________________Postcode__________

Contact_______________

A Sudscape Contracts Director will be visiting at least one of the above to
inspect workmanship
                                                Membership Application form


Section four: Financial



If partnership or sole trader please complete this section.



Partner 1_________________________                                 Partner 2 _______________________

Address_________________________                                    Address ______________________-
______________________________                                    ______________________________

____________________________                                   _____________________________

Date of birth ____________                                                     Date of birth ___________


I/we confirm that the above information is true to the best of our knowledge

I confirm that my company has and will continue to have the necessary insurance cover as described in section 1 of application
form and will supply evidence of cover on request .




             Print Name                                                                             Date

             Authorised Signatory




   Please ensure the following documents are enclosed in the envelope and return to:

         Sudscape Limited, Hints Road, Mile Oak, TAMWORTH B78 3PQ

        Tel: 01827 288533

				
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posted:9/14/2012
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