Please enter the details of your request. A member of our support staff will respond as soon as possible.
Please enter "Not Applicable" if you have not been in contact with our Sales Team
Please state the company name as this appears on the company register
Please state the entity number as this appears on the company register.
Please provide as much detail as possible on which type of products and services you intend to use GoCardless for
For example, you expect to process £200,000 through GoCardless in the next 12 months in total please only insert: 200000
Please state this as a number, not a % i.e if 60% please only insert '60'
*Please insert this as a number only* for example if it is 40 days, please only insert: 40. If there is a further fulfilment split, i.e. 20% is 30 days and 40% is 365 days, then please insert the weighted days ( (20%*30) + (40%*365)). In this example the output would be: 152.
For example, 60% are billed monthly and 40% are billed annually.
Please select the % of chargebacks in value terms
Please select the % of failures in value terms
e.g. 500 (£/$/€) per month in refunds
Please can you attach this to the form. This is required to understand further the future projections of the business
This is required to validate the projections of the business against funding provided
This is to understand the growth plans of the business further
If you are in contact with the GoCardless sales team please ask them for a GC reference number. It could be called Opportunity ID or Account ID.