Account Application New Customer Application Form 1 About You2 About Your Company3 Billing & Trade References4 Insurance & ID Details5 Terms and Conditions About YouFirstly we'll need some basic details such as you name and how we can get in contact with you. Simply fill in the fields below ensuring the information you provide is as accurate as possible. The form will adapt depending on the answers you provide. Fields marked with an asterisk (*) mean they are required and must be completed before you can continue. Your Name* First Last Your Email Address* Enter Email Confirm Email Your Address* Street Address Address Line 2 City AberdeenshireAngus/ForfarshireArgyllshireAyrshireBanffshireBedfordshireBerkshireBerwickshireBlaenau GwentBridgendBuckinghamshireButeshireCaerphillyCaithnessCambridgeshireCardiffCarmarthenshireCeredigionCheshireClackmannanshireConwyCornwallCromartyshireCumberlandDenbighshireDerbyshireDevonDorsetDumfriesshireDunbartonshire/DumbartonshireDurhamEast Lothian/HaddingtonshireEssexFifeFlintshireGloucestershireGwyneddHampshireHerefordshireHertfordshireHuntingdonshireInverness-shireIsle of AngleseyKentKincardineshireKinross-shireKirkcudbrightshireLanarkshireLancashireLeicestershireLincolnshireLondonMerthyr TydfilMiddlesexMidlothian/EdinburghshireMonmouthshireMorayshireNairnshireNeath Port TalbotNewportNorfolkNorthamptonshireNorthumberlandNottinghamshireOrkneyOxfordshirePeeblesshirePembrokeshirePerthshirePowysRenfrewshireRhondda Cynon TaffRoss-shireRoxburghshireRutlandSelkirkshireShetlandShropshireSomersetStaffordshireStirlingshireSuffolkSurreySussexSutherlandSwanseaTorfaenVale of GlamorganWarwickshireWest Lothian/LinlithgowshireWestmorlandWigtownshireWiltshireWorcestershireWrexhamYorkshire County Postcode Main Telephone*Mobile Telephone About YouFirstly we'll need some basic details such as you name and how we can get in contact with you. Simply fill in the fields below ensuring the information you provide is as accurate as possible. The form will adapt depending on the answers you provide. Fields marked with an asterisk (*) mean they are required and must be completed before you can continue. Are you a company or an individual?*CompanyIndividualSole Trader or Limited Company?*Sole TraderLimited CompanyCompany Name Company NumberVAT NumberBilling Details As Above?*Yes (My account details are as above)No (I would like to supply seperate accounts info)Accounts Contact First Last Accounts TelephoneAccounts Email Enter Email Confirm Email Accounts Address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Invoicing DetailsNow we need to know how you prefer to pay, and be paid so we can set up your account. Fields marked with an asterisk (*) mean they are required and must be completed before you can continue. Perfered Payment Method(s)* Cheque BACS CHAPS Cash Other Bank Account No.Sort CodeTrade ReferencesPlease provide us with details of at least two companies or indaviduals within the media industry whome we may contact to ask about your exsisting account standing.Trade Reference 1*Please provide the name of a relvant individual or company you have an existing account with.Trade 1 Contact Details*Trade Reference 2*Please provide the name of another relevant individual or company you have an existing account with.Trade 2 Contact Details* Proof of InsuranceIn order to hire from us you must have equipment insurance, most companies already have this in place, so we'll just need a scan of your "hired in" equipment policy stating the valid date and total insured value. Clients who don't have insurance can get a one off or short term policy by searching for "short term hired in equipment insurance" online.Insurance* Yes, I have insurance and have attached a scan No, I do not have insurance insurance Cover Note*Accepted file types: jpg, jpeg, pdf, doc, gif, png.No Insurance ProvidedWe need insurance to be in place before any hire can be made. We can continue to set up an account but will not be able to hire to you until proof of insurance is supplied. There are a number of companies that offer short term insurance such as Allan Chapman & James, Essex Insurance Brokers, Towergate and Performace.Insurance* I am aware that I must provide proof of insurance before my first hire. Proof of IDWe also need proof of ID that matches the trading address supplied earlier, you can choose to upload this now or bring it along when you collect your equipment. Proof of ID* Yes, I would like to provide ID now No, I will bring ID along when I collect Proof of ID*Accepted file types: jpg, jpeg, pdf, doc, gif, png.No ID ProvidedWe need to validate your identity before any hire can be made. We can continue to set up an account but will not be able to hire to you until proof of ID is supplied and verified, this can take 48 hours, if your hire is ugent we may not be able to process your account in time.Proof of ID* I am aware that I must provide proof of ID before my first hire. Anti Spam FilterWe know these things are annoying but they really help to stop spam getting through the system, simply enter the characters you see below. If you can't read them hit the small refresh symbol and you'll be given another set that's hopefully more legible. Anti Spam SystemAcceptance of TermsBy checking below and submitting this form you agree that all details given above are correct, true, and complete and that you have read and agree to our terms and conditions.Authorisation* I confirm that I am authorised to submit this application on the behalf of the company or individual named above and that the details provided above are correct. Terms and Conditions* Yes, I wish to open an account and agree to be bound to your terms and conditions. NameThis field is for validation purposes and should be left unchanged.