Application Form

01604 604 511

IWA APPLICATION FORM

Please download our application form to print off and complete. Once you send it back one of our team will be in touch shortly.

Company Details
Please complete the following details about your company.
Title*
Name*
First Last
Company name
Registration number
Date established
Date Format: DD slash MM slash YYYY
Trading address*
Street Address Address Line 2 City State / Province / Region Post Code
Email*
Enter Email Confirm Email
Website
Telephone*
Public/Employee Liability
Please provide details of your public/employee liability arrangements.
Employers liability/Public liability renewal date
Date Format: DD slash MM slash YYYY
Please supply copies of your Employers/Public liability.
If you have digital copies, you can upload the documents below. Alternatively, you can post the documents to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG
Please supply copies
Drop files here or
Directors/Partners Information
Please provide full details of Directors/Partners of your company.
Number of Directors/Partners in your business*
Director/Partner 1
Please complete the details below in full.
Title
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone
Date of birth
Date Format: DD slash MM slash YYYY
Director/Partner 2
Please complete the details below in full.
Title
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone
Date of birth
Date Format: DD slash MM slash YYYY
Director/Partner 3
Please complete the details below in full.
Title
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone
Date of birth
Date Format: DD slash MM slash YYYY
Director/Partner 4
Please complete the details below in full.
Title
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone
Date of birth
Date Format: DD slash MM slash YYYY
Director/Partner 5
Please complete the details below in full.
Title
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Telephone
Date of birth
Date Format: DD slash MM slash YYYY
Direct Debit Mandate
Please click here to download a Direct Debit Mandate.

You can upload your Direct Debit Mandate at the bottom of this form.
Company Accountant
Please provide full contact details of the company accountant in the field below.
Title
Name
First Last
Accountancy firm name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Telephone
Suppliers
Please give full details of 2 Principle Suppliers with whom you have an account in the section below.
Supplier 1
Company
Contact name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone
Supplier 2
Company
Contact name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email
Phone
Your Contract / Guarantee / Order Form
Please supply a copy of your Terms & Conditions & Copy Guarantee. These may be uploaded using the fields below or posted to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG
Terms and Conditions
Copy Guarantee
Registration
A registration fee of £100 is required to process your membership. You may make a secure PayPal payment via this form or send a cheque to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG
How do you wish to pay your membership fee?*
- Online payment
- Cheque
- Call the IWA on 01604 654150 to pay over the phone
Online Payment Selected
Once you submit the completed form, you will be directed to the PayPal website where you can make your payment.
Cheque Payment Selected
Please send a cheque for £100 payable to IWA send a cheque to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG
Call the IWA on 01604 654150 to pay over the phone
Please call the IWA on 01604 654150 to pay over the phone.
Business Information
Annual Sales Turnover
Average Contract Value
Primary Source of Business
Number of Contracts per Month
Number of Salesmen
Number of Fitting Teams
Types of Products Installed
Copies of your last 12 months bank statements*
Drop files here or
Authorisation
Authorisation*
- By checking this box, you are committing your signature to this application form.
I/We authorise IWA to make any enquiries necessary in the processing of this application. To the best of my knowledge the above information is true and correct.
Name of authorising person*
First Last
Position of authorising person*
Date*
Date Format: DD slash MM slash YYYY
Direct Debit Mandate
Drop files here or

"The warranty benefits my company through sales advantages, whilst giving my customers peace of mind."

Mike Hibberd, Managing Director, Finesse Energy

"IWA offer a great product and made the whole process quick and straightforward."

Tony Hepher, Managing Director, Marathon Windows

"Our customers are naturally looking for peace of mind... it gives customers reassurance and helps consolidate the final sale."

Charles Robertson, Owner of Radley Aylesbury Ltd

IWA APPLICATION FORM

Please download our application form to print off and complete. Once you send it back one of our team will be in touch shortly.

Company Details

Public/Employee Liability

Please supply copies of your Employers/Public liability.

Directors/Partners Information

Director/Partner 1

Director/Partner 2

Director/Partner 3

Director/Partner 4

Director/Partner 5

Direct Debit Mandate

Company Accountant

Suppliers

Supplier 1

Supplier 2

Your Contract / Guarantee / Order Form

Registration

Online Payment Selected

Cheque Payment Selected

Call the IWA on 01604 654150 to pay over the phone

Business Information

Authorisation

ABOUT IWA

LEGAL

Application Form

IWA APPLICATION FORM

Please download our application form to print off and complete. Once you send it back one of our team will be in touch shortly.

Company Details

Public/Employee Liability

Please supply copies of your Employers/Public liability.

Directors/Partners Information

Director/Partner 1

Director/Partner 2

Director/Partner 3

Director/Partner 4

Director/Partner 5

Direct Debit Mandate

Company Accountant

Suppliers

Supplier 1

Supplier 2

Your Contract / Guarantee / Order Form

Registration

Online Payment Selected

Cheque Payment Selected

Call the IWA on 01604 654150 to pay over the phone

Business Information

Authorisation

ABOUT IWA

LEGAL

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