Application Form

Fill in the form below to apply. Fields marked with a * are required.

Application Form Guide

SIC code

Standard Industry Classification (This code is used when submitting a companies annual return or find your company on the companies house web site) Link .

The SIC code is shown ? down the page on the left hand side.

Entering numbers into boxes

Only enter numbers; Don't be tempted to enter words, commas, decimal points, or spaces. Take particular care with when entering telephone numbers not to include any spaces.

EEE Production Information

Enter the amount of EEE in tonnes and kilograms that your company put on the market during 2007 in that category for either Business to Business or Business (B to B) to Consumer markets (B to C) . Every box (26 boxes) must contain a number or a 0 . For your company most boxes will contain a 0 if that particular category of waste does not apply to your company.

All information entered below will be kept strictly confidential. In the event that you become a member of the Advantage Waste Brokers scheme, you will be informed of which data will be needed to be submitted to the regulator under statute.

Producer Information

Please make sure all relevant information is entered.

†GB Pound Sterling as per last accounts.

Company Name *

Company Number

Business Name (if different from company name)

Partnership Name (if different from company name)

Partner 1

Partner 2

Trading Name (if different from company name)

SIC Code 1

SIC Code 2

SIC Code 3

SIC Code 4

SIC Code 5

VAT Number

Turnover† *

Obligation Type *

Principal Contact and Organisational Details for your Company

Title *

Forename *

Surname *

Telephone (no spaces) *

Mobile (no spaces) *

Fax

Email *

Principal Address - Contact Name *

Organisation Name *

Premises Number/Name *

Address Line 2 *

Address Line 3

Town *

City

County *

Postcode *

Administration Area

Billing Address *

EEE Production Information by Category

EEE produced annually by Category (figures for 2007) as applicable to your company (in tonnes and kilograms).

	B2B	B2C
Large Household Appliances *			Tonnes and Kilograms
Small Household Appliances *			Tonnes and Kilograms
IT and Telecoms Equipment *			Tonnes and Kilograms
Consumer Equipment *			Tonnes and Kilograms
Lighting Equipment *			Tonnes and Kilograms
Electrical and Electronic Tools *			Tonnes and Kilograms
Toys, Leisure and Sports *			Tonnes and Kilograms
Medical Devices *			Tonnes and Kilograms
Monitoring and Control Instruments *			Tonnes and Kilograms
Automatic Dispensers *			Tonnes and Kilograms
Display Equipment *			Tonnes and Kilograms
Cooling Appliances Containing Refrigerants *			Tonnes and Kilograms
Gas Discharge Lamps *			Tonnes and Kilograms

Extra Information

Do you have public liability insurance?

Do you have a health and safety policy?

Do you have an equal opportunities policy?

Do you have an environmental management policy?

Any collection or transporting of waste by Advantage Waste Brokers Limited is subject to Advantage Waste Brokers Limited's Standard Terms and Conditions of Sale/Purchase - January 2007 and Advantage Waste Brokers ltd compliance scheme supplementary membership rules and guidance.

Advantage Waste Brokers Ltd; Company No. 4748329 registered at Companies house Cardiff . Registered office is 22 St. John Street , Bromsgrove, Worcestershire B61 8QY | Terms and Conditions available on request | Copyright Advantage Waste Brokers January 2008

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