Colony By Night Application Form

About you
Your Name*

First NameLast Name
Job Title*
Company Name
Your Email Address*
example@example.com
Date of Birth*

DayMonthYear
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Please use the camera on your phone/laptop to provide a photo of yourself
Word of mouthGoogleSocial mediaRecommended by a friendAttended an eventOther

Virtual Office

Please select your Virtual Office from the options below*

Virtual Office

A professional address for the receipt of business mail, as an alternative to using your home address. Price includes £10.00 of VAT

£60.00 for each month

Virtual Office (with company registered address)

A professional address for the receipt of business mail, as an alternative to using your home address. Use of The Colony address for your registered business address with Companies House. Price includes £17 of VAT

£102.00 for each month

Premium Virtual Office (with company registered address)

A professional address with a dedicated, secure mailbox for the receipt of business mail, as an alternative to using your home address. Use of The Colony address for your registered business address with Companies House. Price includes £22 of VAT

£132.00 for each month

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature

Clear
Should be Empty:

About you

Virtual Office