Register to become a seller for Contact State.

To start the process of becoming an approved Contact State seller, please fill in this form and our compliance team will come back to you.

Contact name *

Contact number *The best phone number to reach you on about this registration

Contact email *

Contact LinkedIn URL *The full URL to your LinkedIn profile

Company name *

Companies house number *

Registered trading address *

Trading from *When did you start trading? e.g. March 2017

Director(s) names *Comma separated list of directors names

Turnover *What is your annual turnover?

Are you already an IAR or AR of another firm or Directly Authorised? *

If yes please detail here

FCA registration number *

ICO registration number *

Has a company director of this business ever been fined, censured or been the subject of a FCA, ICO or ASA complaint? *

If yes, please detail below.

Are you already integrated with Contact State?Please check the box if you are integrated

Landing page URL's *All of the landing page URL's you use to generate leads

Type of advertising used *e.g. PPC, Native, Email, Social

Advertising approach *If you use email, please detail your approach to email marketing, data ownership and third party suppliers

What other products do you generate leads for? *

I agree that Contact State can contact me to discuss this application

We'll get in touch within 48 hours Mon-Fri. We'll never sell your details or spam you. View our Privacy policy