Retailer Enquiry Form (A1)

Please note: all fields marked with an asterisk (*) must be completed in order to submit the form.

SECTION A – AGENT BUSINESS DETAILS
Please enter your shop name
Please enter your shop address
Please enter your shop post code
SECTION B – BUYING GROUP STATUS
SECTION C - OPENING HOURS
From
To
From
To
From
To
SECTION D - MOBILE PHONE VOLUMES
Average Sales per week (£) * If you are processing mobile phone top ups, please submit a copy of your most recent invoice from your current supplier
Average Sales per week (£)
Average Sales per week (£)
SECTION E – DEBIT AND CREDIT
Average sales per week (£)
e.g. Streamline
SECTION F – ATM CASH MACHINE
e.g. Hanco
SECTION G – MONEY TRANSFER SUPPLIER
e.g. Western Union
Average sales per week (£)
SECTION H - EPOS
SECTION I – OTHER KEY INFORMATION
Average sales per week (£)
Average sales per week (£)
SECTION J