HouseWeb Supplier Registration Form

Please provide the following details. For additional help hover the mouse over This is the help symbol. It will give you additional information & tips on filling out the form where available.
Company Details
Company Name    
Building No./Name    
Street    
Village/Area    
Town    
County    
Post Code   
Country
Has the business been trading for more than 3 years?
Does the business have a clean credit and legal history?
Can you provide three references

Main Contact
First Name     
Last Name    
E-mail Address    
Telephone    
Mobile    
Fax    

Technical Contact     (Tick if same as main contact )
First Name     
Last Name    
E-mail Address    
Fax    

Billing Contact      (Tick if same as main contact )
First Name     
Last Name    
E-mail Address    
Telephone    
Fax    

Billing Address     (Tick if same as above address )
Building No./Name    
Street    
Village/Area    
Town    
County    
Post Code   
Country

Sign-In Details
E-mail Address to send Customer Requests     This is the address where the customer's requirements will be sent. Please double check that this address is correct.
Password    (min 5 characters) Your password will be used to access the future supplier extranet. Please make a note of it.
Re-enter Password    

Services & Products
Enter your Services & Products that you can offer homeowners and/or movers.
Service/Product  Geographical Coverage    Enter which areas you can deliver this product or service. If it is UK-wide, state "UK", if in England, state "England". If only regional coverage is available, enter the region (e.g. South East), county (e.g. Surrey) or list the Postcode areas (e.g. SW1, SW2)
(UK, Countries, Regions, Counties or Postcode areas).
1.       
2.       
3.       
Additional Services & Products (please list below with geographic details)

Terms & Conditions