NHS Registration Form

If you are a NHS Organisation wishing to use WEMWBS you can purchase an annual licence online (up to 30,000 Participants).

Please note that this form is for NHS organisations only, if your email address does not contain NHS in the suffix you need to apply using the main commercial licence application form.

For up to 50 participants £75
For up to 100 participants £125
For up to 250 participants £250
For up to 500 participants £375
For up to 1,000 participants £600
For up to 3,000 participants £1125
For up to 5,000 participants £1375
For up to 10,000 participants £1875
For up to 15,000 participants £2250
For up to 20,000 participants £2625
For up to 30,000 participants £3000

Please complete the form below to register and pay for your licence, ensuring that you read and accept the terms and conditions.

If you wish to offer WEMWBS to a greater number of Participants we would be happy to discuss your requirements. Please submit your enquiry, along with some information on how you would like to use the scale hereLink opens in a new window and we will come back to you.

Please note, all Commercial Organisations utilising WEMWBS require a Commercial Licence including where WEMWBS is being used as part of products or services offered to non-commercial customers or in non-commercial settings.

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How are you planning to use WEMWBS?

Type of use

If other, please specify

Community

NHS

School(s)

Workplace or occupational setting

Church or spiritual organisation

Social services (including care home setting)

University or college

Other

Preferred version of WEMWBS
(Note – both versions of WEMWBS can be used under a single licence)

11-17

18-64

65+

Start Date
(Note – the Annual Licence Period is 12 (twelve) months from the Start Date)

Scale of Use: Please select the licence you require based on the total number of individuals you will make WEMWBS available to (Participants) during the Annual Licence Period

Organisation

Organisation name

Industry/Sector

Size of Organisation (no. of employees)

Organisation Address

Country of Organisation

Website

Company Registration Number

Is your organisation turnover less than €50 million or are your organisations total assets less than €43 million? if unknown enter unknown

Do you have a parent company, if so, please insert their name, if unknown please enter unknown

The information we are asking for is required for us to meet our mandatory government data reporting guidelines, if you have any queries about this please email wemwbslicence@warwick.ac.uk

Contact details

Contact Name

Job Title

If other, please specify

Yes

Commercial Terms and Conditions

Yes

If you require a VAT Receipt please click here you will receive a receipt for your online payment but will not automatically receive a VAT invoice/receipt.

Please only complete this form if you are making payment via our online payment system. To avoid any delays to your invoice processing please ensure you complete all required fields.

We are unable to issue a VAT invoice/receipt until payment has been made online

Privacy notice

The University of Warwick will process your personal data, being your contact details for the purpose(s) of licence registration, management and academic research

The legal basis for processing this personal data is that it is necessary for the performance of a contract and a public task

Your personal data will not be shared or disclosed to any third parties external to the University of Warwick, unless you have ticked yes to the box above, at which point we will share your personal data with third parties for the purposes of product development of WEMWBS.

Your personal data will not be transferred outside of the EEA, will be kept securely by the University of Warwick and will be retained for up to 5 years and used for licence management and academic research.

The University of Warwick is the Data Controller of this information and is committed to protecting the rights of individuals in line with Data Protection Legislation. Please visit the University’s Data Protection webpages for further information in relation to your rights and how the University processes your personal data. The University’s Data Protection Officer can be contacted through infocompliance@warwick.ac.uk and any requests or complaints should be made in writing to the University’s Data Protection Officer.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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