IT & Telecoms Payment Details

Thank you for showing your interest in taking part in the IT & Telecoms research.

Your payment will be sent via BACs transfer, please note that this process can take up to two weeks

Please fill in your details below and make sure all are correct and up to date

None of this information is ever passed onto any third parties and stored securely

Many thanks,

The Members Team

Your Contact Details

Your Contact Details

First Name *

*THIS IS HOW WE HAVE YOUR NAME WRITTEN ON OUR DATABASE*

Surname *

*THIS IS HOW WE HAVE YOUR NAME WRITTEN ON OUR DATABASE*

Please write your FULL NAME as it appears on your bank statements

Daytime Contact Telephone Number *

*THIS IS THE DAYTIME CONTACT NUMBER WE HAVE FOR YOU - PLEASE CHECK THIS IS CORRECT*

Alternative Contact Telephone Number

Email Address *

*THIS IS THE EMAIL ADDRESS WE HAVE FOR YOU - PLEASE CHECK THIS IS CORRECT*

Your Bank Details

Please fill out your SORT CODE *

Please fill out your ACCOUNT NUMBER *

Please fill out the NAME OF YOUR BANK *

Please let us know of any further information we need to know before transferring your payment

This information will be held confidentially and securely by Roots Research Ltd in accordance with the Data Protection Act 1998 and Market Research Society Code of Conduct.

I understand that my information will only be used to provide me with the opportunity to participate in occasional paid research. I am aware that I am under no obligation to participate and I am entitled to have my data removed at any point. *

Agree

Disagree

Δ