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SECTION 1
Name......................................................................................... Job Title..................................................................................... Company................................................................................... Address ..................................................................................... ...................................................................................................
.................................................................Postcode..................
Telephone.................................................................................. Fax............................................................................................. Email.......................................................................................... Website......................................................................................
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Please sign and date for your free copy of Independent Electrical Retailer
Signature ............................................Date...............................
What is the best description of your business? (please tick one only)
1A Independent Electrical Retailer 1B Multiple Retailer 1C Service and Repair of Electrical Goods 1D Electrical Goods Distributor 1E Manufacturer / Supplier 1F Other (please specify)
....................................................................................................... What is your main job title? (please tick one only)
2A Proprietor / Owner 2B Chief Executive / Director / MD 2C Shop Manager 2D Finance 2E Purchasing / Buying 2F Service 2G Sales / Marketing 2I
Other (please specify) ....................................................................................................... How many employees are there in your organisation?
3A 1/Sole Trader 3B 2-4 Employees 3C 5 to 9 Employees 3D 10 to 19 Employees 3E 20 to 49 Employees 3F 50 to 99 Employees 3G 100 to 499 Employees 3H 500 + Employees
Please tick all products/services you sell in your shop/store
4A Audio/Soundbars/DAB Radio 4B Audio/Video Accessories, Spares and Consumables 4C Built-in Appliances 4D Computers/Multi-Media 4E Cookers & Hobs 4F Digital Cameras 4G DVD/Blu-Ray Home Cinema Systems 4H Electric Heating Appliances 4I
Floorcare Appliances
4J Freestanding Appliances 4K Hair/Personal Care Appliances 4L Repairs/Servicing 4M Satellite Equipment 4N Small Kitchen Appliances 4O Tablets & eBooks 4P Telephone/Mobile Phones 4Q LCD/LED/3D Televisions 4R TV/DVD/Blu-Ray Hire 4S None of the above
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