Your first nameis required
Your last name is required
Email is required
Contact number is required
Your date of bith is required. Format: DD/MM/YYYY or DD-MM-YYYY
Business name is required
Business address is required
City is required
Postcode is required
Business website is required
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
Please read and accept the terms and conditions
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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