Sign-up Now

[contact-form to=’partners@diskeng.com’ subject=’DiskEng Partnership Sign-up’]
Thank you for your interest in the DiskEng Authorised Partner Scheme.

Complete the application form below for your DiskEng Partner membership.

Please complete all sections.

Membership Contact Details

[contact-field label=’First Name’ type=’name’ required=’1’/]
[contact-field label=’Last Name’ type=’name’ required=’1’/]
[contact-field label=’Email Address’ type=’email’ required=’1’/]
[contact-field label=’Mobile Number’ type=’text’/]
[contact-field label=’Job Title’ type=’text’ required=’1’/]
[contact-field label=’Job Role’ type=’text’ required=’1’/]
[contact-field label=’Department’ type=’text’ required=’1’/]

[contact-field label=’Subscribe to newsletter’ type=’checkbox’/]

Membership Company Details

[contact-field label=’Company’ type=’text’ required=’1’/]
[contact-field label=’Address 1′ type=’text’ required=’1’/]
[contact-field label=’Address 2′ type=’text’/]
[contact-field label=’City’ type=’text’ required=’1’/]
[contact-field label=’County’ type=’text’ required=’1’/]
[contact-field label=’Postcode’ type=’text’ required=’1’/]
[contact-field label=’Country’ type=’text’ required=’1’/]
[contact-field label=’Business Phone’ type=’text’ required=’1’/]
[contact-field label=’Industry’ type=’text’ required=’1’/]

Full partnership requires DiskEng Partner logo and direct website link

[contact-field label=’Full Partnership (20%25 Discount or 20%25 Commission)’ type=’checkbox’/]
[contact-field label=’Company Website’ type=’text’/]

Optional, Referral Commission Payee Account

[contact-field label=’Bank or Building Society Name’ type=’text’/]
[contact-field label=’Trading Account Name’ type=’text’/]
[contact-field label=’Account Number’ type=’text’/]
[contact-field label=’Sort Code’ type=’text’/]
[contact-field label=’Company Tax Id’ type=’text’/]
[/contact-form]

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