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SECTION 1


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1A Independent Electrical Retailer 1B Multiple Retailer 1C Service and Repair of Electrical Goods 1D Electrical Wholesaling / Distribution 1E Manufacturer / Supplier 1F Other (please specify)


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Title.....................Name..................................................................................Job Title..................................................................... Company .......................................................................................................................................................................................... Address............................................................................................................................................................................................. ........................................................................................................................Postcode................................................................... Telephone .......................................................................................................Fax............................................................................ Email Address .................................................................................................................................................................................. This information may be used as selection criteria for carefully configured promotions. If you wish to be excluded tick here


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3A Both Brown and White Goods 3B Brown Goods only 3C White Goods only 3D None of the above


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