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Your Details

First Name: *required
Surname: *required
Address 1: *required
Address 2:
Town/City: *required
Postcode: *required
Mobile: *required
Email address: *required


Your Target AREAS

Please indicate which of our standard regions that you target in your agency activities. *required


To view the regions rollover the map below.

Then select your region(s) from the checklist on the right

Select as many as needed to reflect the area you cover or are prepared to cover.

Please select any and all regions that you cover, even if only partially.

Please note that regions are based on postcode areas and not counties. The map shows the counties of the UK with the postcode regions overlaid in yellow. And there is a degree of overlap between some regions.



Northern Ireland
Republic of Ireland

North East

North West
(inc. N. Wales)
South West
(inc. S. Wales)
South East
(inc. London)
South Midlands
East Midlands
West Midlands
(inc. Mid Wales)
All UK
Do you cover the UK only or UK & International: UK Only
UK & International



Further information about your AREA:

Please tell us more about the geographical area that you cover.
For example anything that you cannot express using our standard categories above.



Please tick the standard market sectors that you cover, or that you're interested in, below.

You may select any and all markets that you cover, even if only partially. (10 max)


Architects / Surveyors / Interior Designers   Jewellers
Bakers / Butchers   Kitchen Specialists
Booksellers   Leather / Travel Goods
Builders / Decorators Merchants / Building Contractors   Legal: Solicitors And Barristers
Camping / Outdoor Leisure / Fishing / Equine   Leisure Centres / Gyms / Health Clubs
Cash & Carry / Wholesale / Distributors   Local Government Authorities
Chemists / Pharmacy / Drug   Mail Order
Clothing / Fashion / Textile   Marine Chandlers
Computer Suppliers   Motor Accessories
Cook Shops   Music / TV / Publishing / Media
Corporates / Offices   New Age Retail
CTN (Confectioners, Tobacconists, Newsagents)   Nursing / Residential Homes
Dentists / Doctors / Vets   Off Licences And Wine Merchants
Direct Selling (Householders)   Pet Retail / Wholesale
Discount / Pound Shops   Photographic / Camera
DIY / Hardware / Ironmongery   Post Offices
Drapers / Haberdashers   Printing & Graphics
Electrical Goods / Lighting / Electronics / Telecom   Private Training / Educational
Engineers / Consulting Engineers   Pubs / Clubs
Estate Agents   Restaurants / Caterers / Hotels / Cafes / Snack Bars
Fabrics / Linens / Soft Furnishings   Schools / Colleges / Universities / Education Authorities
Factories / Engineering / Manufacturing / Industrial   Security
Footwear   Sports Goods / Sportswear
Furniture / Upholstery   Stationers
Garages / Motor Repairs / Car Sales   Supermarkets / Multiples
Garden Centres / Florists / Horticulture   Timber Industry
Gift / China / Glass / Cards / Department Stores   Toys, Novelties, Hobbies
Golf Clubs   Visitor Centres / Tourist Attractions
Grocers / Convenience Stores / Petrol Stations / Delicatessens   Logistics
H.M. Forces   Arts / Crafts / Galleries
Hairdressers / Beauty & Tanning Salons   Financial Services
Health Food Stores   Opticians
Hospitals   Childcare / Nurseries / Playschools
Housewares / Homestores   Internet / Web

Further information about your MARKETS:

Tell us anything that you cannot express using our standard categories above.



Please tell us about what you currently sell, and/or what you are looking for.


Products / services carried now:
Products / services sought:

(What are you looking for?)



Please tell us a little about your activities as a self-employed, commission-only sales agent.


When did you first become an agent?
(eg. 2008)
Number of active customers:
Previous products / services sold:


My past or other experience

Please tell us about your other / previous relevant experience and skills.

(I.e. before you were an agent, or other current business activities such as franchises, distributorships, etc)


Sales experience (give details, include nature and number of years):
Other relevant experience, skills, qualifications, etc:
Anything else you feel of relevance:


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