Contractor Sign Up

Step 1 of 7

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Payment Method*

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

Company Details

Please complete the following details about your company.

Title*

Name*

First Last

Company name

Registration number

Date established

DD slash MM slash YYYY

Trading address*

Street Address Address Line 2 City State / Province / Region Post Code

Email*

Enter Email Confirm Email

Website

Telephone*

Public/Employee Liability

Please provide details of your public/employee liability arrangements.

Employers liability/Public liability renewal date

DD slash MM slash YYYY

Please supply copies of your Employers/Public liability.

If you have digital copies, you can upload the documents below. Alternatively, you can post the documents to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG

Please supply copies

Drop files here or

Max. file size: 512 MB.

Products*

Air Source Heat Pumps

Bathrooms

Bedrooms

Biomass Boilers

Boilers

Central Heating Systems

Conservatories

Double Glazed Doors

Double Glazed Windows

Extensions

Fascias

Garage Conversions

Garage Doors

Garden Rooms

Ground Source Heat Pumps

Kitchens

Loft Conversions

Loft Insulation

Orangeries

PV Management Systems

PV Solar

Roofing

Roofline

Soffits

Thermal Solar

Please tick all that apply

Which of the following are you registered with?

FENSA

CERTASS

ASSURE

RECC

MCS

Other

Please tick all that apply

Guarantee period provided on your contract

Guarantee Period 2 years

Guarantee period 5 years

Guarantee period 10 years

Directors/Partners Information

Please provide full details of Directors/Partners of your company.

Number of Directors/Partners in your business*

Director/Partner 1

Please complete the details below in full.

Title

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Date of birth

DD slash MM slash YYYY

Director/Partner 2

Please complete the details below in full.

Title

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Date of birth

DD slash MM slash YYYY

Director/Partner 3

Please complete the details below in full.

Title

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Date of birth

DD slash MM slash YYYY

Director/Partner 4

Please complete the details below in full.

Title

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Date of birth

DD slash MM slash YYYY

Director/Partner 5

Please complete the details below in full.

Title

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone

Date of birth

DD slash MM slash YYYY

Company Accountant

Please provide full contact details of the company accountant in the field below.

Title

Name

First Last

Accountancy firm name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Telephone

Suppliers

Please give full details of 2 Principle Suppliers with whom you have an account in the section below.

Supplier 1

Company

Contact name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Phone

Supplier 2

Company

Contact name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Your Contract / Guarantee / Order Form

Please supply a copy of your Terms & Conditions & Copy Guarantee. These may be uploaded using the fields below or posted to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG

Terms and Conditions

Max. file size: 512 MB.

Copy Guarantee

Max. file size: 512 MB.

Registration

A registration fee of £100 is required to process your membership. You may make a secure PayPal payment via this form or send a cheque to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG

How do you wish to pay your membership fee?*

Online payment

Cheque

Call the IWA on 01604 654150 to pay over the phone

Online Payment Selected

Once you submit the completed form, you will be directed to the PayPal website where you can make your payment.

Cheque Payment Selected

Please send a cheque for £100 payable to IWA send a cheque to IWA at:
IWA,
18 & 19 BABBAGE HOUSE
NORTHAMPTON SCIENCE PARK
KINGS PARK ROAD
MOULTON PARK
NORTHAMPTON
NN3 6LG

Call the IWA on 01604 654150 to pay over the phone

Please call the IWA on 01604 654150 to pay over the phone.

Business Information

Annual Sales Turnover

Average Contract Value

Primary Source of Business

Number of Contracts per Month

Number of Salesmen

Number of Fitting Teams

Types of Products Installed

Authorisation

Authorisation*

By checking this box, you are committing your signature to this application form.

I/We authorise IWA to make any enquiries necessary in the processing of this application. To the best of my knowledge the above information is true and correct.

Name of authorising person*

First Last

Position of authorising person*

Date*

DD slash MM slash YYYY

Direct Debit Mandate

Please click here to download a Direct Debit Mandate.

You can upload your Direct Debit Mandate below.

Direct Debit Mandate

Drop files here or

Max. file size: 512 MB.

Contractor Sign Up

Fill in the form below and one of our team will be in contact shortly.

Company Details

Public/Employee Liability

Please supply copies of your Employers/Public liability.

Directors/Partners Information

Director/Partner 1

Director/Partner 2

Director/Partner 3

Director/Partner 4

Director/Partner 5

Company Accountant

Suppliers

Supplier 1

Supplier 2

Your Contract / Guarantee / Order Form

Registration

Online Payment Selected

Cheque Payment Selected

Call the IWA on 01604 654150 to pay over the phone

Business Information

Authorisation

Direct Debit Mandate