Sign up form on start up ebusiness -

All fields marked with an * are required.

Step 1 of 3. Tell us a bit about you and your shop...

Product Type:* Website Name:* This can not be changed

Your address (URL) of your store will be:

http://www.shopcreator.com/mall/

Later you can buy your own domain (www.mystore.com) within the store admin.

Name:*

Email Address:* (Login details are sent here.)

Telephone Number:*

Date of Birth:* (Minimum sign up age 18.)

Where did you hear about us?*

Type of business:

Address:*

Town/City:*

Postcode/ZIP Code:*

Country:

Your 14 day trial is completely FREE! If you continue with your site you can cancel at any time. No lock in. Simply email us at support@shopcreator.com and your account will immediately be cancelled.

Step 2 of 3. Enter Your Payment details...

Your card will NOT be charged until after your trial has expired. If you wish to cancel, you may do so at any stage during your trial without incurring any charges.

Card Type*

Card Number*

Name on Card*

Expiry Date* /

Start Date /

Issue Number (Enter if shown on Maestro Card)

CVV* (MasterCard, Visa and Discover credit cards have a 3 digit code printed on the back of the card while American Express cards have a 4 digit code printed on the front side of the card above the card number.)

Your 14 day trial is completely FREE! You can cancel your account at any time. Your card details are held securely and will only be used if you continue with your site.

Step 2 of 3. Fill in your direct debit details...

Service User Number

69 2866

Selfserve (UK) Ltd

5 Carrwood Park

Selby Road

Leeds

West Yorkshire

LS15 4LG

Pay Selfserve (UK) Ltd by Direct Debit

Your Direct Debit request has been received

If the bank account has dual signatory then please print off and complete the paper version of the direct debit mandate, complete the required details and return it to us.

You will need Adobe's Acrobat software to read the Direct Debit form. You can download this software here.

Accounts:0113 287 8432 or email accounts@shopcreator.com

Instruction to your Bank or Building Society to Pay Direct Debit

Name(s) on Account(s):*

Name 2 - optional

Account Number:*

Bank Sort Code:*

- -

Your 14 day trial is completely FREE! You will NOT be charged during the trial period. You can cancel your account at any time. Your bank account details are held securely and will only be used if you continue with your site.

Instruction to your Bank or Building Society

Please pay Selfserve (UK) Ltd Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with Selfserve (UK) Ltd and, if so, details will be passed electronically to my Bank/Building Society.

*PLEASE NOTE; Banks and Building Societies may not accept Direct Debit Instructions for some types of accounts.

The Direct Debit Guarantee

Last update January 2010

This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.
The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.
If an error is made by Selfserve (UK) Ltd or your Bank or Building Society you are guaranteed a full and immediate refund from your branch of the amount paid.
You can cancel a Direct Debit at anytime by writing to your Bank or Building Society. Please also send a copy of the letter to us.

Step 3 of 3. Read and agree to our Terms & Conditions...

Note: By signing up for this site, you are agreeing to Shopcreator's Acceptable Use Policy.

I Agree To the Terms and Conditions

Store Creation can take a few minutes. Please be patient.

Any questions please contact sales direct on 0845 12 11 400 or email sales at sales@shopcreator.com

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