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Company details:

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Company name:
Trading as:
Address:
City:
County:
Post code:
Country:
Telephone:
Website:
How did you hear about The KeepWell Mark:
Please describe your business (e.g. pharmaceutical, financial services, technology):

(e.g. pharmaceutical, financial services, technology)
Please select the main industry under which your organistation operates:
Approximately how many employees in the company:

Contact details:

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Contact name:
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Email address:
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Main role in company:
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Members' participation in the Keep Well programme is subject to the Terms and Conditions of Ibec Membership and any other terms and conditions relating to the Ibec Keep Well programme as may be communicated to members from time to time.

Data Protection

To the extent that any personal data is processed by Ibec on members' behalf as part of the Keep Well programme, it will be processed in accordance with the Terms and Conditions of Ibec Membership and Ibec's Privacy Statement which may be accessed here.

Please check the box if you would like to receive further information from Ibec [by post or email] about the Keep Well programme and other [related] topics we believe may be of interest to you.