Registration

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Registration To complete your membership application we will now require your address details. After you submit this form an invoice will be sent to you for the sum of £300. Once your payment is received, the Administrator will activate your account and confirm this by e-mail. You can then begin using Alliance Employment Risk for the next 12 months.
First name
Surname
Email Address
Number of Employees
Company
Address

City
Counties
Postcode
Telephone Number
Fax Number	[optional]
Web Address	http:// [optional]
Company Description	[optional]
Agree to Terms & Conditions	[you must tick this box to proceed]

REMEMBER YOUR PASSWORD! You will need this password each time you log on

Username	[choose a username]
Password	[choose a password]
Confirm Password

* unless stated all fields are required to be completed.