Become a Titan Partner

Complete the form to become a partner

Company Name *

Trading Name (If Different)

Registration Number *

VAT Number *

Nature of Business *

Telephone *

Company URL *

Date Established *

Credit Limit Required *

Credit Limit Currency *

Are you a member of a buying group? If so, please state which. *

Business Addresses

Registered Office *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Delivery Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Invoice Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Key Contacts

Email Address: Invoices *

Invoices are sent via email. Please list an email address.

Email Address: Price Lists *

So that we can send future information to the correct contact, please list an email address.

Proprietors Details

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Proprietors Acknowlegement

Titan may carry out enquiries with credit agencies on the address of any director or proprietor shown above for the purpose of assessing this account application. Titan requires your consent before we can carry out such searches. If you agree please sign below.

Print Name *

Date *

Signature *

Clear Signature

Accounts Payable Details

Contact Name *

First

Last

Contact Number *

Contact Email *

Purchasing Manager Details

Contact Name *

First

Last

Contact Number *

Contact Email *

Vendor Relationship Manager Details

Contact Name *

First

Last

Contact Number *

Contact Email *

Accountants / Auditors Details

Company Name *

Contact Name *

First

Last

Contact Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Bank Details

Name of Bank *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Sort Code *

Account Number *

High Court & County Court Judgements

Have any High Court or County Court Judgements been registered against your business? *

References

Please provide two references who we may contact to help support the requested credit limit (one must be an I.T distributor)

Ref 1: Company Name *

Ref 1: Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ref 1: Contact Number *

Ref 2: Company Name *

Ref 2: Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ref 2: Contact Number *

Business Profiling

This section is intended to give us a greater understanding of your business.

Core Business Focus *

Vendor Focus *

Vertical Markets *

Acknowledgement

I confirm that the above information is correct and agree to the terms and conditions of Titan Data Solutions as attached. (Must be signed by a Partner or Company Director)

Print Name *

Signature *

Clear Signature

Date *

Custom Captcha *

Message