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AdviserNet order form - For commercial, statutory, and member organisations
This is the AdviserNet order form for commercial, statutory and member organisations. Please ensure that you provide full and accurate information; failure to do so will simply result in a delay in processing your application. Please also take the time to read our licensing terms and conditions before submitting.
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* Indicates required question
Name of company, statutory body, or member organisation (please provide the full name as registered with Companies House, Charity Commission, or similar. Please do not state a trading name as that will not be accepted for this agreement):
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Your answer
Website address for your company:
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Your answer
Name of nominated contract manager: (Please note that this needs to be a member of your senior management team)
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Your answer
Job/Role title of nominated contract manager:
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Your answer
Email address for your contract manager:
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Your answer
Telephone number (direct dial) for your contract manager:
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Your answer
Name of nominated service manager:
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Your answer
Job/Role title of nominated service manager:
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Your answer
Email address for nominated service manager:
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Your answer
Telephone number (direct dial) for nominated service manager:
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Your answer
Registered charity number (if applicable):
Your answer
Registered company number (if applicable):
Your answer
Registered Financial Conduct Authority number (if applicable):
Your answer
Contact business address
for your organisation (NOT a personal address): (Please provide the full postal business address for your organisation, with post code.):
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Your answer
Invoice address (if different from above):
Your answer
Email address for invoicing. (If invoices need to be sent to your Finance Dept, please provide the relevant email address here):
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Your answer
Please tell us your preferred payment type. If you opt for payment by direct debit, please note that the direct debit must be set up at the start of your 12-month licensing period):
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We would like to be invoiced only for a 12-month subscription
We wish to pay our invoice by direct debit and have the £25 reduction in licensing fee costs. (if you selection this option, Citizens Advice will email you a direct debit form)
Will you be raising a Purchase Order for the payment of your AdviserNet subscription fee? {If you answer 'yes', then please note that you will be asked to advise us of the PO number before we invoice you for the fee.)
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Yes
No
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