Register as a priority customer

The fields marked with an asterisk (*) are required.

Title

This field is required

First name

This field is required This field has a maximum limit of 15 characters

Surname

This field is required This field has a maximum limit of 15 characters

Contact number (preferably mobile)

This field is required Mobile numbers should be between 11 and 25 digits long

Secondary contact number

Landline numbers should be 11 digits long

Email
If you wish to be contacted via email

This field is required This is not a valid email address (e.g. johnsmith@domain.com) This field has a maximum limit of 100 characters

Address
Start typing a street name or postcode

This field is required

{[{user.SubBuilding}]}, {[{user.AddressLine1}]}, {[{user.BuildingName}]} {[{user.AddressLine2}]}, {[{user.AddressLine3}]}, {[{user.City}]}, {[{user.Postcode}]}

Wrong address? Re-enter it again or click below to enter your address manually.

Sub building

This field is required This field has a maximum limit of 970 characters

Building Number

This field is required This field has a maximum limit of 30 characters

Building Name

This field is required This field has a maximum limit of 970 characters

Address Line 1

This field is required This field has a maximum limit of 80 characters

Address Line 2

This field has a maximum limit of 30 characters

Town/City

This field is required This field has a maximum limit of 30 characters

Postcode

This field is required This field has a maximum limit of 10 characters

Postcode is not within the Electricity North West area

Contact preference

Phone Text Email

This field is required

Nominated contact name

Nominated contact number

Visitor password

Reason for wanting to join
Please select all that apply

How did you hear about us?

This field is required

Please give details
Maximum 50 characters

This field is required

Please confirm that you give your consent to share

I agree for Electricity North West to share my personal data, (including sensitive personal data) with my electricity, water and gas supplier and transporters so that they can include me on its priority service register, contact me for the purposes of its priority services register and to otherwise process my personal data for the purposes of operating this priority service register.

Confirmation

I can confirm that all of the information that I have given you is correct.

This field is required

Form completed by? (Full name)

This field is required

Please note that if you are registering on behalf of someone else and are nominating yourself as next of kin please be aware we will make direct contact with the individual being registered to confirm consent for their personal data to be processed as set out in this form.

Register or update your details

Register or update your details as a priority customer