APPLICATION FORM SIBA SUPPLIER ASSOCIATE MEMBER

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We hereby submit our application to join the Society of Independent Brewers.

Contact Details

Company Name:

Full Company Name

Trading Name:

Full Trading Name

Company Number

Address line 1:

Address line 2:

Address line 3:

Town

County:

Post Code:

Company Tel No.

Include area code

Vat Registration Number

Website address:

This will be used on the links section of our website

Company Email Address:

Please select the Category of Ownership for your company

Please provide names of the following where relevant:

Sole Trader

Partners of Directors

This application contains a declaration of the names of any persons who influenced or were beneficiaries of any previous member company and are now in any way associated with the company making the application

Who should SIBA use as their contact?

Please fill in this section with the details of the person within your organisation that deals with SIBA.

SIBA Contact Name:

For SIBA Correspondence

SIBA Contact Position

Position of contact above

SIBA Contact Email:

Email address of above

Supplier Associate Category

Category Includes Total Cost (Oct 20 - Sept 21)

Standard SIBA Benefits £399.00

Please select the relevant Membership Category (details below)

Standard Membership

Membership Policy Acceptance

By clicking the box below you confirm that you will undertake and abide by the SIBA Handbook (available here)

I/We confirm we have read and accept the terms and conditions laid out in the SIBA Handbook.

SIBA Publicity

Pleas tick to confirm you have read & accept SIBA's Privacy Notice, that can be found here

How did you hear about SIBA?

What are your main reasons for joining SIBA? (Please list unto three)

Trade directory

50 word description for our publications:

Select Category

Payment of Subscription Fees

Payment of renewal subscriptions is by Direct Debit only

Click Here to download the SIBA Direct Debit Mandate

Upload Direct Debit Mandate

What happens next?

Your subscription will be calculated, and you will receive an invoice for payment within 48 hours from submission of application form

SIBA Office Use Only

User

Password

Region

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Contact Information