Name of company

Contact name

Telephone

Fax

Email

Address

Postcode

Website

Briefly describe your business for the website listing (max 25 words)

Describe your discount / special offer for Bags of Change customers (max 15 words)

How many bags would you like to order? (Minimum order 10 in total)

Organic hemp cotton bag (GREEN)

Organic hemp cotton bag (RUST)

Organic hemp cotton bag (BLUE)

Fairly traded wild treetap rubber bag

All the information we receive will be published on our website and included in the next consumer newsletter. It is essential that you inform Bags of Change immediately if any of the details change. Please note that by joining Bags of Change, you are agreeing to offer the discount or special offer detailed above.

I agree to offer the discount specified to all Bags of Change customers when they shop with their bag and am responsible for informing Bags of Change of any alterations to the above information.

I would like to register for premium membership at £48 per annum.

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Date

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