New Site Form

NEW CUSTOMER FORM

Uhelp AGENT:

Date:

PHONE:

COMPANY NAME:

ADDRESS (STREET):

EMAIL:

CHARITY AMBASSADOR’S NAME – (CA)

CHARITY AMBASSADOR’S EMAIL – (CA)

NUMBER OF STAFF:

TYPE OF BUSINESS:

DELIVERY DETAILS:

Parking Detail (best place to park):

Name of Business on the Front Door

Building Entrance Instructions (inc. Security Code – if applicable)

Position of Box (e.g tea room):

Special Access Instructions:

NOTES:

DELIVERY DETAILS:

BOX BAR CODE: