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Please Complete ALL fields marked with * |
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*First Name |
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*Last Name |
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*Company name |
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*Postcode |
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*Telephone – Daytime |
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Evening |
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* Mobile |
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Fax |
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* Email |
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* Is your email connected to your mobile phone? |
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Yes
No
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* Do you have ACS Accreditations? |
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Yes
No
(you will be required to show evidence of this should your application be approved) |
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* Public liability insurance |
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Yes
No
(you will be required to show evidence of this should your application be approved)
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* Are you Gas Safe Registered?
If so, what is your Gas Safe Number? |
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Yes
No
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* Do you have City & Guilds 6084 in Energy Efficiency Central Heating? |
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Yes
No
(you will be required to show evidence of this should your application be approved) |
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* VAT Registered |
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Yes
No
Vat No
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* How long have you been trading? |
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* Do you operate a 24-hour call out? |
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Yes
No |
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* The number of jobs you can do? |
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* The days you can work? |
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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* Do you carry out boiler repairs and servicing work? |
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Yes
No |
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* Do you carry out electric boiler repair work? |
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Yes
No |
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* Please tick the types of fuels you work on |
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Natural Gas
LPG
Oil
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* Do you carry out landlord safety inspection work? |
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Yes
No |
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* Do you carry out installation work and what are the preferred boiler(s) you install? |
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Yes
No |
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* Do you carry power flushing? |
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Yes
No |
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* Do you carry out energy efficiency control upgrades? |
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Yes
No |
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* Do you carry out under floor heating installation work? |
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Yes
No |
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* Do you carry out solar heating installation work? |
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Yes
No |
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* Do you carry out air source heat pumps installation work? |
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Yes
No |
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Do you carry out plumbing work? |
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Yes
No |
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Do you carry out full bathroom installations? |
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Yes
No |
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* What areas are you prepared to cover? Surrounding postcode areas covered – e.g., M, CH, BN etc |
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How did you find our website: |
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if parts supplier, please state who |
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Discount/Membership Fee is £40.00
Please tick to acknowledge that you have
read the T&Cs and agree to them.
I agree to your Terms and Conditions |
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