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Type of customer

Payment Type

Company Name Rescue Center Name

Contact Name Contact Name (in relation to application)

E-Mail Address Contact E-Mail (in relation to application)

Telephone Number Phone Number (in relation to application)

Invoice Address Shipping Address

Shipping Address Invoice Address Use a different shipping address Use a different invoice address

Company type

Company Registration Number (Ltd company only)

VAT Number

Place of Business

Place of Business (other)

Website

Kennel Club Affix, GCCF or CA prefix

Where do you intend to purchase Breeder Bags?

Do you currently feed Arden Grange?

What food did you previously feed?

Number of dogs owned

Do you breed, work or show your dogs?

Do you own a boarding kennels?

Main Contact

Name of Dog and Registration number Registration Charity Number

How many sites does the Rescue have?

What is the Rescue?

What capacity of dogs/cats can the Rescue care for at one time?

Roughly how many dogs/cats are rehomed each month?

Referrer

I agree to the T&C.

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