Enterprise Application Forms

Boxes marked * are required

Registered Company Name:*

Trading Name:

Registered Company Address*:

Post Code*:

Telephone Number*:

Web Address:*

VAT Number:*

Company Registration:*

Partner Contact Name:*

Partner Contact Number:*

Partner Contact Email Address:*

Facebook:

Twitter:

Instagram:

LinkedIn:

Partner Program

For "Brodit Enterprise Plus Partner" program, you must submit two case studies.

Enterprise Partner Program Type:

Case Study 1:

Case Study 2:

Nemesis Account Number:

Nemesis Account Manager:

Nemesis Account Type:

Years Trading with Nemesis:

Last 6 Months Spend (£):

Last 12 Months Spend (£):

Full Name:*

Completion Date:*

I have understood the standard terms and conditions.*

Please tick the box if you wish to receive emails from Nemesis about pricing, products & promotions. We will not pass your details to a 3rd party.

Please leave this box empty: