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About you - the company representative

Your first nameis required

Your last name is required

Email is required

Contact number is required


About the business

Description is required

Business address is required

City is required

Postcode is required

Business website is required

Business name is required

Business trading name is required

Company number is required, format: 00000000


About you - some extra bits

Your address is required

City is required

Postcode is required

Your date of bith is required. Format: DD/MM/YYYY or DD-MM-YYYY


Company ownership

Please list all other individuals who own more than 25% of the company, or are in a position to exercise significant control of the company’s finances and operations. Examples of individuals who exercise significant control may be chief operating officers or financial officers.


select an onwership percentage

Do you own more than 25% of this business, or do you exercise significant control?

Please let us know if there are other business owners

If you are not an owner, you must supply owner details

Are there other individuals who own more than 25% of the company?

First name is required

Last name is required

Address is required

City is required

Postcode is required

Date of birth is required, format: DD/MM/YY or DD-MM-YY

Ownership percentage is required



Company Directors

Company directors include all members of the board of directors, or any other person appointed to direct the company's affairs. Directors may also be owners of the company.


Please let us know if you are a director of the business

Are you a director of this business?

If you are not a Director, you must supply company Director details

Please let us know if there are additional company directors

Are there other individuals on the board of directors?

First name is required

Last name is required



Bank details

Please provide your company’s bank account number and sort code so that we can process payments for transactions completed on the Wriggle Platform.


Sort code is required, format: 000000

Account number is required, format: 00000000

Account numbers must match


Terms & Conditions

Please read and accept the terms and conditions


Direct debit confirmation

Wriggle will process payments to your nominated bank account via regular automated direct debits and in line with the schedule agreed with Wriggle (2-4 days in arrears, every week or every month). By submitting this form you confirm that you are able to authorise debits, and that you request and authorise Wriggle to initiate transfers to and (in the case of customer refunds) from your nominated bank account through the Bankers’ Automated Clearing Services (BACS).


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