Personal Account Application Form

1
Name of company * This field is required.(Mandatory field)
2
Company registration number* This field is required.(Mandatory field)
3
Company address* This field is required.Current business address (Mandatory field)
House name or number
Street Address
City
Postcode
County
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Company status* This field is required.(Mandatory field)
Limited Company
Sole Trader
Partnership (LLP)
5
VAT registration number (where applicable)
6
What does the company do* This field is required.Business description i.e. logistics / construction (Mandatory)
7
How long has the company been established?(Optional)
8
Your name * This field is required.(Mandatory field)
First Name
Last Name
9
Your job title* This field is required.(Mandatory field)
10
Your email address* This field is required.Your full email address (Mandatory field)
example@example.com
11
Mobile telephone number (Optional)
12
Business telephone number * This field is required.(Mandatory field)
13
Preferred email address for documentation to be sent over* This field is required.ex: RA, check sheet - full email address (Mandatory field)
example@example.com
14
Who will be our main fleet contact* This field is required.email address / name/ telephone number (Mandatory field)
15
Who do we need to liaise with reference vehicle damage?* This field is required.email address / name/ telephone number (Mandatory field)
16
Who do we need to liaise with regarding PCN?* This field is required.email address / name/ telephone number (Mandatory field)
17
Who do the vehicle rental agreement's and check sheet's need to be sent to?* This field is required.email address / name/ telephone number (Mandatory field)
18
Are you the fleet decision maker?* This field is required.(Mandatory field)
YESNO
19
Your fleet acquisition methodHope you presently acquire your vehicles (Optional)
Leased
Rented
Purchased
20
What types of vehicles you operate(Optional)
Cars
Small Vans
Medium Vans
Large Vans
Tippers
Crewcabs
Dropsides
Traffic Management Spec
21
Your fleet size* This field is required.(Mandatory field)
0-9
10-24
25-49
50-99
100-199
200+
22
Which suppliers do you presently deal with for your vehicles?(Optional)
23
Fuel Cards* This field is required.
Yes
No
Do you currently have fuel cards?
How many active fuel cards do you have?
What is your estimated monthly spend?
24
Insurance* This field is required.
Who is your current insurance provider?
When is your current insurance due to expire?
25
Do you currently have telematics or cameras fitted?* This field is required.
YESNO
26
Name on bank account (as it appears)* This field is required.(Mandatory field)
27
Bank Name* This field is required.(Mandatory field)
28
Bank Address* This field is required.(Mandatory field)
House name / number
Street Address
City
Postcode
County
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
29
Bank Account Number* This field is required.(Mandatory field)
30
Bank Account Sort Code* This field is required.(Mandatory field)
31
Please upload your company letterhead here, you will NOT be able to proceed with an application without uploading this * This field is required.(This is a mandatory requirement)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
32
Please upload your fully comprehensive insurance certificate here. If you have individual insurance and require therefore the specific registration number then simply upload a note advising us of this fact. It can be scribbled on paper, or typed, but we must be advised why your insurance cannot be completed. If you do not upload either the insurance document or the reason why, you will NOT be able to proceed with this application * This field is required.(This is a mandatory requirement)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
33
Please upload your completed direct debit form here. If your company policy is not to pay by direct debit, then simply upload a note advising us of this fact. It can be scribbled on paper, or typed, but we must be advised why you are not following our mandatory payment method. If you do not upload your completed direct debit form or the reason why, you will NOT be able to proceed with this application * This field is required.(This is a mandatory requirement)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
34
Additional information checklist* This field is required.(Mandatory confirmation response)
A copy of your company letterhead
35
Additional information checklist(Optional)
A copy of your fully comprehensive insurance
36
Additional information checklist(Optional)
A copy of your fully completed direct debit form
37
Confirmation points* This field is required.(Mandatory response)
I can confirm that the information provided is factual and correct
38
Confirmation points* This field is required.(Mandatory response)
I give consent to Global Go! Limited to conduct a credit check in order to validate and complete the account application process
39
Confirmation points* This field is required.(Mandatory response)
I acknowledge, understand and accept that my vehicle will be fitted with telematics in line with the anti-terrorism and fraud policy of Global Go! Limited and its funders. I further understand, acknowledge and accept that if the telematics unit is removed for any reason then a charge of £179.00 + VAT will be charged to me and an additional telematics unit will be fitted
40
Contact and communication* This field is required.(Mandatory response)
I consent to Global Go! Limited retaining and using this information in relation to any business transacted with myself
41
Contact and communication(Optional response)
I consent to Global Go! Limited using my information for the purpose of marketing (exclusive to their company) and would like to be made aware of offers and services from time time as they become available.
42
Whom with Global Go! have you been liaising?If nobody please state NONE (Optional)
43
Date* This field is required.
Date
Year
Month
Day
44
Finally, is there any other companies that you would recommend that we speak to regarding business opportunities?
45
Signature * This field is required.Mandatory signature confirming all points required)
ClearSigned for and on behalf of the account applicant
Should be Empty: