Agents Registration Application

Sales Agents, please complete the following form to join the M-SMC Agents Register, or to update your current entry:

Only Sales Agents operating in the UK and Ireland will be entered on to our records.

Your details please:                               

Address	*
Address
Town	*
County
PostCode

Telephone
Other Telephone
Mobile Telephone
Facsimile
E-mail	*

Territory Information:             

Please list the Counties you work:

The list of Companies you sell for will remain confidential, please list below each Company name in the first box and a brief description of their products in the second box:

Please tick the Retailing sectors you mainly trade with or want more of:

Enter any other comments in the space provided below:

Help us to avoid spamming botnets, enter the word AGENTS in this box:
using uppercase letters.

Fields marked with a * must be completed

Only Sales Agents operating in the UK and Ireland will be entered on to our records.
If you want a copy of the completed form, use the Print button on your browser.