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Go Digital Application

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Sales Partner Name:
You must enter your name so that we know who is responsible for this application
Sales Partner Name
Field is required!
Field is required!
Legal Business Details
Merchant/Company Legal Business Name
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Field is required!
Trading as (if different)
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Field is required!
Trading details
Trading Address
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Field is required!
City
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Postcode
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Field is required!
Company registration number (if applicable)
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Field is required!
VAT number (if applicable)
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Field is required!
Contact Details
Company phone number
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Field is required!
Company Email Address
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Field is required!
Website
Field is required!
Field is required!
Type_of_Entity
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Field is required!
Enter Other Company Type
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Field is required!
Business Classification
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Field is required!
Other Business Classification
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Field is required!

Main Contact details

Personal responsible for website and online elements (main contact)
Title:
  • - select your title -
  • Mr.
  • Mrs.
  • Miss.
- select your title -
Field is required!
Field is required!
First Name
First Name
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Field is required!
Last Name
Last Name
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Field is required!
Position:
Role Held
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Field is required!
Main Phone number
Main contact number
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Field is required!
Main Email
Email Address
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Field is required!

What service(s) is required

Service required:
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Field is required!
Further Information:
Explain what they are interested in
Further information
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Field is required!

Current Website details (if applicable)

Only required if they are looking at websites or online shops only
Current website provider:
WordPress, GoDaddy, Squarespace, Wix, Other
Field is required!
Field is required!
How much do they pay for site?
Approximate monthly or annual cost (domain, website or both)
Field is required!
Field is required!
When does their contract/agreement end?
Month, year...
Field is required!
Field is required!
Would they move hosting or supplier?
In some cases we may need to transfer their current domain, we can save money in most cases.
  • - select a option -
  • Yes
  • No
  • Maybe
  • Unsure
- select a option -
Field is required!
Field is required!

Legal Information

By signing below, the Applicant(s) certifys that all documents and information submitted in connection with this application, authorise Cashflow Advance Ltd, its employees and management team to share this information exclusively for the purposes of (i) considering the entry into an agreement with Cashflow Advance Ltd for online products, and (ii) monitoring our performance during the life of such agreement, and (iii) collection activities by authorised agents in case of default or fraud protection. The personal information we have collected from you will be shared with our relevant partners, where applicable, for purposes of supplying online products as agreed. Further details of how your information will be used by us and these fraud prevention agencies, and your data protection rights, can be obtained directly from Cashflow Advance Ltd.

Signed by/on behalf of the aforementioned company:

By signing I agree I have permission on behalf of the company to agree to services; both one off and ongoing.
Authorised Signature (1):
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Field is required!
Print Full Name
Applicant One Full Name
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Field is required!
Date of signature
Select a date
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Field is required!

Signed by/on behalf of the aforementioned company:

By signing I agree I have permission on behalf of the company to agree to services; both one off and ongoing.
Authorised Signature (2):
Field is required!
Field is required!
Print Full Name
Applicant Two Full Name
Field is required!
Field is required!
Date of signature
Select a date
Field is required!
Field is required!

Data Protection (GDPR)

We are registered in England and Wales under company number 13001801, and our registered office address is Manor House, Howbery Park, Wallingford Manor House, Howbery Park, Wallingford, England, OX10 8BA. We are registered as a data controller with the Information Commissioner’s Office. We respect your right to privacy and will only process personal information you in accordance with the Data Protection Legislation which for the purposes of this policy shall mean: (i) unless and until the GDPR is no longer directly applicable in the UK, the General Data Protection Regulation ((EU) 2016/679) and any national implementing laws, regulations and secondary legislation, as amended or updated from time to time, in the UK and then (ii) any successor legislation to the GDPR or the Data Protection Act 1998 and other applicable privacy laws.
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