Services Required

Unreserved Co-Working space YesNo

Reserved Co-Working space YesNo

Frequency DailyWeeklyMonthly

Car Parking Space YesNo

Date of Co-Working Member arrangement to commence

Personal Details

Full Name

Home Address

Postcode

Email Address

Telephone Numbers

Have you ever had any County Court judgements against you?YesNo

Have you ever been convicted of a criminal offence? YesNo

Emergency Contact Details

Full Name

Home Address

Postcode

Email Address

Telephone Number

Company Details

Full Company Name:

Business structure LTDCOSole TraderPartnershipLLP

VAT Registered YesNo

Company Website

Current registered business name and address

Post Code

How long have you used this as your business address?

How long have you been in business for?

Nature of business

How long have you been trading and approx. turnover?

References (Names and Addresses)

Please provide two business referees, one from your current premises landlord (if applicable) and the second from a business relationship.

Current Premises Landlord Name

Address

Email

Name of Referee

Business Name and Address

Email

Nature of Working Relationship (eg. Trade, Contractor, Supplier)

I hereby give permission for the above referee’s to be contacted for the purposes of ascertaining my company’s eligibility to use the HatTech Business Centre Co-Working membership services.