Assosia Field Team

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Security Details

We may need to contact you to confirm payment details and require you to select a Password for these kinds of calls. This MUST be kept private!

More About You

Questionnaire

Bank Account

Provide Later? Select this option if you want to give us your bank details later on. We need this to make payments to you for any work you do for us. You can provide this after you have done your first job if you wish. I would like to supply Bank details later on.

UK Bank Account If you have a foreign bank account, i.e. not in the UK then please untick this box to switch to the IBAN/SWIFT form. I have a bank account with a UK bank.

Building Society Is your account a building society? My account is a Building Society

Account Holder Name* The name of the account holder
(e.g. John Smith).

Sort Code* A six digit code (12-34-56) that identifies the bank. - -

Account Number* Your 8 digit account number (12345678).

Roll Number* Your building societies roll number.

Please provide your IBAN as this helps you to avoid any bank charges!

Account Reference* The type of account reference/number you have.

IBAN (Recommended)

Account Number (Not Recommended)

IBAN* Your International Bank Account Number. Recommended!

Account Number* Your 8 digit account number (12345678).

SWIFT Code* Society for Worldwide Interbank Financial Telecommunication Bank Identifier Code.

Account Holder Name* The name of the account holder
(e.g. John Smith).

Bank Name* For example HSBC or Santander

Bank Address* Address details for your bank.

Payment Notes Any notes you think are relevant for making a payment to your account, such as the intermediary bank etc.

I agree to the standard terms and conditions as outlined in the Field Associate Contract. By ticking this box, you also confirm that all information you have submitted above is correct and true and you have not omitted any relevant or pertinent information, which may affect your role in being an Assosia shopper.

We must stress that any and all information you acquire working on any Assosia Ltd project should be treated as private and strictly confidential and must not be passed on in any way or form to anyone outside of the Assosia Ltd network.

Thank you for completing this application form. We will process your application and send you a full associate pack confirming that we have added you to our database. As soon as work becomes available in your area, we will contact you to discuss your availability and confirm the project specific instructions. Please do not hesitate to contact us if you would like any further information.

tel: +44 (0) 1708 444840,
fax: +44 (0)1708 455833
or e-mail agent@assosia.com.

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