Business priority form

Join our business extra care register

This is a FREE service to help reduce the impact of power cuts to our business customers

The fields marked with an asterisk (*) are required.

Title

This field is required

First Name

This field is required This field has a maximum limit of 30 characters

Surname

This field is required This field has a maximum limit of 30 characters

Contact Number

This field is required Contact numbers should be between 11 and 25 digits long

Email address

This field is required This is not a valid email address (e.g. johnsmith@domain.com) This field has a maximum limit of 100 characters

Secondary email address

This is not a valid email address (e.g. johnsmith@domain.com) This field has a maximum limit of 100 characters

Organisation name

This field is required This field has a maximum limit of 30 characters

Address
Start typing business name, street name or postcode

This field is required

{[{user.SubBuilding}]}, {[{user.AddressLine1}]}, {[{user.BuildingName}]} {[{user.AddressLine2}]}, {[{user.AddressLine3}]}, {[{user.City}]}, {[{user.Postcode}]}

Wrong address? Re-enter it again or click below to enter your address manually.

Sub Building

This field is required This field has a maximum limit of 970 characters

Address 1

Address must have either building name, building number or both This field has a maximum limit of 30 characters

Building Name

Address must have either building name, building number or both This field has a maximum limit of 970 characters

Address 2

This field is required This field has a maximum limit of 80 characters

Address 3

This field has a maximum limit of 30 characters

Town

This field is required This field has a maximum limit of 30 characters

Postcode

This field is required This field has a maximum limit of 10 characters

Postcode is not within the Electricity North West area

Industry Sector

This field is required

Contact Preference

Phone SMS Email

This field is required

Do you need electricity to operate?

Yes No

This field is required

Do you have your own backup generator?

Yes No

This field is required

I can confirm that all the information I have given you is true and correct. This field is required

Business extra care form

Join our business extra care register