CISAS Membership Application
Please complete this form and and submit online. Upon receipt, CISAS will send you a membership contract for review and signature.
If you have not already received an information pack about the CISAS service please contact Miss Holly Quinn by email: firstname.lastname@example.org.
Include all brands you would like to be covered by CISAS.
Company Registration Number
Company Street Address
Estimated Annual Deadlocked Complaints
Please provide an estimate of the number of deadlocked complaints you expect will be referred to CISAS per annum.
0 to 12 cases
13 to 24 cases
25 to 50 cases
50 to 100 cases
Over 100 cases
What date would you like the contract to start.
Case Handlers Name
Please provide details of the employee who should be contacted if CISAS receives a claim about your company.
Team Name (If Applicable)
If you have a team of people in place to deal with CISAS cases please provide the group details.
Team Telephone Number
Accounts Department Contact Name
Please provide the details of the employee who we should send our invoices to.
Accounts Telephone Number
Accounts Email Address
Line Manager Job Title
Line Manager Name
Who should CISAS contact on matters of best practice, up-dates on CISAS processes and stage one compliance matters?
Line Manager Telephone Number
Line Manager Email
Senior Manager Name
Who should we contact for matters related to the contract with CISAS and stage two compliance matters?
Senior Manager Job Title
Senior Manager Telephone Number
Senior Manager Email
Brand(s) further information
Please provide us with your brand(s) website and contact details if they are different to the ones you have already provided:
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