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AGENTS APPLICATION

Please print, complete and post to the below address. Your Portal will be live, functional and ready to accept applications within 5 days of receipt. A confirmation letter will also be sent to you.

Paying by debit/credit card will ensure you site is live within 24 hours of receiving payment. Please click here to pay by card.

Bronze Package (40%) £99  
Bronze Package (40%) + Domain £119  
Silver Package (60%) £149  
Silver Package (60%) + Domain £169  
Gold Package (80%) £249  
Gold Package (80%) + Domain £269  
Total £

Please also choose your desired names.

www.elender.co.uk/  

Domain Name to be registered (if applicable). If your desired name is not available, you will be contacted with suggested alternatives.

1st Choice www.
2nd Choice www.
3rd Choice www.

Full Name  
Address  
Contact No  
Email  

Please make cheque or Postal Order payable to
‘E-urohost’

Please post to E-lender, (Agents Dept), Head Office,
35 Blades Street, Lancaster, LA1 1TT.
E-lender is part of the E-urohost Group.