CIPS Account ID
                                                                   SUPPLIER APPLICATION FORM
               New Supplier                Amendments
               1. Company Contact Details
               Sole Trader                 Partnership              Limited/Plc               VAT Number
                                                                                      Year Commenced Trading
               Company Name                                                           Company Reg Number
               Registered Address
               County                                                                 Postcode
               Country
               Telephone                                                              Fax
               Email                                                                  Website
               Trading Address
               (if different)
               County                                                                 Postcode
               2. Sales Account Manager Contact Details
               Name                                                                   Direct Dial
               Position                                                               Direct Fax
               Address
               3. Service
               Please provide brief detail of service/products:
               4. References (only suppliers where CIPS spend greater than £1000) THESE MUST NOT BE CIPS TRUSTEES
               1  Company                                                             Contact Name
                  Address
                  County                                                              Postcode
                  Telephone                                                           Email
               2  Company                                                             Contact Name
                  Address
                  County                                                              Postcode
                  Telephone                                                           Email
               5. Bank details
               Account Name                                                           Bank Name
               Bank Address
               County                                                                 Postcode
               Account Number                                             IBAN Number (if applicable)
               Sort Code                                                  SWIFT Number (if applicable)
               A copy of your bank details must also be provided on letter headed paper. Payment will be made by BACS
                 6. Insurance (only suppliers where CIPS spend greater than £1000)
                                                        Value of Cover          Renewal Date              Policy Number                        Name of Insurer
                 Public Liability
                 Employers Liability
                 Contractors All Risk
                 Professional Indemnity
                 Other/Third Party
                 7. Quality (only suppliers where CIPS spend greater than £1000)
                 Is your company BS EN ISO 9001 registered?
                 if yes, please supply a copy
                 8. Company Policies (only suppliers where CIPS spend greater than £1000)
                 Do you have an Equal Opportunities policy?                     if yes, please provide a copy
                 Do you have a Disciplinary and Appeals policy?                 if yes, please provide a copy
                 Do you have a Testing policy?                                  if yes, please provide a copy
                 Do you have a Business Continuity Plan?                        if yes, please provide a copy
                                                                                    ESSENTIAL DOCUMENTS
                 Check List
                  * All suppliers complete sections 1, 2, 3 and 5. Suppliers where CIPS spend greater than £1,000 complete all sections
                  * Copies of insurance policies/documentation (if applicable)
                  * Latest published company accounts
                  * Copies of any relevant certifications including trade associations etc (if applicable)
                  * Bank details on letter headed paper
                                                                                         DECLARATION
                 For and on behalf of this organisation:
                 I warrant that the statements and particulars contained in this application are true and complete and give specific authority to The Chartered Institute of 
                 Procurement and Supply to seek financial reports and other references concerning the Company
                 I  have read, understand and accept The Chartered Institute of Procurement and Supply Standard Terms and Conditions and agree to trade in accordance with these. 
                 I understand that completion of this questionnaire does not guarantee that I/we will be asked to tender for or provide services or supply any goods in the future
                 I confirm that there are no restrictions and/or obligations outstanding from any other previous or current contracts or agreements with any other parties which 
                 restricts our ability to contract with CIPS
                 I / we have read, understand and agree to abide by The Chartered Institute of Procurement and Supply's 'Code of Ethics'
                 Signature:                                                                        Name:
                 Position:                                                                         Date:
                               COMPLETION OF THIS QUESTIONNAIRE DOES NOT GUARANTEE THAT YOU WILL BE INCLUDED ON OUR LIST OF REGISTERED SUPPLIERS
                                           Failure to submit all information requested in this questionnaire may result in your application being rejected
                 CIPS INTERNAL USE ONLY
                 CIPS CONTACT                                                   CREDIT CHECKED BY
                 SUPPLIER CREDIT CHECK REQUIRED?                                YES                           NO
                 DATE CREDIT CHECK                                              DELPHI SCORE
                 APPROVED
                 DECLINE                          REASON