Title: * Mr Ms Mrs Miss

Contact Person (first and last name): *

Business Name: *

Street Address (We need your repair shop address): *

Town / City: *

Postcode: *

Set your location on the map (enter full UK postcode): *

(You can adjust your location on the map further by dragging the blue pin)

Country: *

United Kingdom

Telephone No.: *

Secondary Telephone No.:

Website Address:

Repair Centre Manager (first and last name): *

Can you repair Apple devices? *

Yes No

Select the type of repair service you offer? *

Walk-in service (i.e. customer comes to you)
Mail-in service (i.e. customer mails device to you)
Call-out service (i.e. you go to the customer).

We repair the following devices: *

Email Address: *

Confirm Email Address: *

Password: *

Confirm Password: *

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