COMPANY NAME: *

TRADING AS (IF APPLICABLE): *

COMPANY REGISTRATION NUMBER: *

COMPANY VAT NUMBER: *

REGISTERED ADDRESS:

DELIVERY ADDRESS (IF DIFFERENT TO THE ABOVE):

SERVICES PROVIDED (PLEASE LIST ALL SEPARATED BY COMMAS):

ARE YOU A MEMBER OF ANY ACCREDITED REGISTERS (EG JCCP, SAVE FACE)?

DO YOU, OR MEMBERS OF YOUR TEAM, HOLD ANY PROFESSIONAL QUALIFICATIONS?

CONTACT INFO

NAME:

TELEPHONE:

EMAIL:

Where I/We provide you with personal data, I/we understand that the data will be held securely in confidence and processed for the purpose of your Business and associated activities. In considering my/our application, I/we accept that you may consult with and disclose the data to credit reference agencies, banks, credit insurers and other responsible organisations outside your business that you have nominated (third parties), and that such third parties may process the data. I/we understand that under the Act I/we have a right to know what data you hold on me/us if I/we apply to you in writing and pay the applicable fee. I have read and accept the Privacy Policy available online at https://knownnutrition.com/pages/privacy-policy

I agree Terms and Conditions I/We agree to sell Known Nutrition products directly to customers from our business premises only or over the phone. I/We may advertise the availability of Known Nutrition products online and via Social Media, but I/we agree there will be no function to purchase Known Nutrition products online or via Social Media.

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