Name of Organisation
Primary Address
Postcode
Country
Telephone
Fax
Email
Website
Do you trade under any other name? If yes, please provide name(s)
Is your organisation part of a larger organisation? If yes, please provide name
Nominated Management Representative
Deputy Management Representative
How many sites in the UK?
How many sites overseas?
How many products/licences are included in this application?
PRODUCT/LICENCE DETAILS.	Please include name or product and number of licences sold or in use per annum
Product/Licence 1
Product/Licence 2
More Products/Licences
OPERATING SYSTEM Requirements for Submitted Product	Windows Apple Macintosh Other
Operating System Version. Please also specify "other"
BROWSER CAPABILITY	MS Internet Explorer Opera Safari Netscape Firefox Others All/Independent of browser
Browser version. Please also specify "other"
Category of Product	Type A Type B
METHOD OF DELIVERY TO CONSUMER	Boxed prouct available from retailers Software download Product as a service feature of other product
Please specify download file size OR name of product parent
Which media type will be submitted for testing?
HELPLINE DETAILS
Helpline Telephone Number
Cost of helpline
Helpline operating times
Helpline consumer email address
Helpline consumer URL
Helpline Online consumer URL
METHOD OF FILTER OPERATION	This question is optional and confidential. An NDA can be provided if required.Filter software (algorithm/lookup list on computer) Filtering done on remote product supplier server Filtering done on remote 3rd party supplier server
	NDA Required?Yes No
How do consumers receive filter content updates?	Download to consumer computer Regularly (Daily,weekly, as required) Monthly Updates not required Other
Please specify "other"
	How are updates performed?Automatically Manually
METHOD OF PAYMENT FOR CONSUMER	Product Type AOne-off purchase price - with subscription One-off purchase price - no subscription
	Subscription Period - Type AAnnual Monthly Other
Please specify "other"
	Product Type BService included with initial purchase - no subscription Service included as part of main product - subscription required
	Subscription Period - type BAnnual Monthly Other
Please specify "other"
SUBMITTED BY
Name
Job Title
Date