diff --git a/lib/templates/new_request_notification.erb b/lib/templates/new_request_notification.erb
index 1847e90..70d729a 100644
--- a/lib/templates/new_request_notification.erb
+++ b/lib/templates/new_request_notification.erb
@@ -9,18 +9,13 @@
 </p>
 
 <ul>
-  <li>
-    Name: <%= api_user.full_name %>
-  </li>
-  <li>
-    Email: <%= api_user.email %>
-  </li>
-  <li>
-    Company: <%= api_user.company %>
-  </li>
-  <li>
-    Reason for using the api: <%= api_user.reason %>
-  </li>
+  <li>Name: <%= api_user.full_name %></li>
+  <li>Email: <%= api_user.email %></li>
+  <li>Company: <%= api_user.company %></li>
+  <li>Type of User: <%= api_user.kind || "N/A" %></li>
+  <li>Has licence? <%= api_user.has_licence || "N/A" %></li>
+  <li>Licence Number: <%= api_user.licence_number || "N/A" %></li>
+  <li>Reason for using the api: <%= api_user.reason %></li>
 </ul>
 
 <p>To activate this user, follow <a href="<%= activation_url %>">this link</a> and insert your administration credentials.</p>
diff --git a/web/controllers/requests.rb b/web/controllers/requests.rb
index 0e57166..9f4894e 100644
--- a/web/controllers/requests.rb
+++ b/web/controllers/requests.rb
@@ -25,12 +25,15 @@ def send_notification(new_user)
 
   def create_api_user params
     ApiUser.create(
-      email:      params["email"],
-      full_name:  params["fullname"],
-      company:    params["company"],
-      reason:     params["reason"],
-      active:     false,
-      token:      ApiUser.new_token
+      email:          params["email"],
+      full_name:      params["fullname"],
+      company:        params["company"],
+      reason:         params["reason"],
+      licence_number: params["licence_number"],
+      has_licence:    params["has_licence"],
+      kind:           params["kind"],
+      token:          ApiUser.new_token,
+      active:         false
     )
   end
 end
diff --git a/web/public/custom.js b/web/public/custom.js
index 0bfae91..a234fb4 100644
--- a/web/public/custom.js
+++ b/web/public/custom.js
@@ -7,7 +7,7 @@ $(document).ready(function() {
 
     $accordionEl.find(".js-trigger").click(function(ev) {
       $switchEl.toggleClass('is-open is-closed');
-      $targetEl.toggleClass('u-hide');
+      $targetEl.toggle();
     });
   };
 
@@ -21,7 +21,7 @@ $(document).ready(function() {
     var $targetEl = $dismissableEl.find(".js-target").addBack(".js-target");
 
     $dismissableEl.find(".js-trigger").click(function(ev) {
-      $targetEl.addClass("u-hide");
+      $targetEl.hide();
       ev.preventDefault();
     });
   };
@@ -29,4 +29,12 @@ $(document).ready(function() {
   dismissables.each(function(i, dismissableEl) {
     dismissOnClick($(dismissableEl));
   });
+
+  $(".js-licence-select").change(function(ev) {
+    if($(this).val() == "Yes") {
+      $(".js-licence-input").show();
+    } else {
+      $(".js-licence-input").hide();
+    }
+  });
 });
diff --git a/web/views/admin.rhtml b/web/views/admin.rhtml
index 18a20ad..b915bdc 100644
--- a/web/views/admin.rhtml
+++ b/web/views/admin.rhtml
@@ -32,18 +32,13 @@
             <div>
               <h4 class="alert__title alert__title--info"> Token: <%= api_user.token %> </h4>
               <ul class="alert__body">
-                <li>
-                  Name: <%= api_user.full_name %>
-                </li>
-                <li>
-                  Email: <%= api_user.email %>
-                </li>
-                <li>
-                  Company: <%= api_user.company %>
-                </li>
-                <li>
-                  Reason for using the api: <%= api_user.reason %>
-                </li>
+                <li>Name: <%= api_user.full_name %></li>
+                <li>Email: <%= api_user.email %></li>
+                <li>Company: <%= api_user.company %></li>
+                <li>Type of User: <%= api_user.kind %></li>
+                <li>Has licence? <%= api_user.has_licence %></li>
+                <li>Licence Number: <%= api_user.licence_number || "N/A" %></li>
+                <li>Reason for using the api: <%= api_user.reason %></li>
               </ul>
             </div>
           </aside>
diff --git a/web/views/request.rhtml b/web/views/request.rhtml
index 60a9e2a..74a5c76 100644
--- a/web/views/request.rhtml
+++ b/web/views/request.rhtml
@@ -15,32 +15,7 @@
         <div class="cover-story__story-border"></div>
         <div class="cover-story__story-body cover-story__story-body--right">
           <div class="cover-story__story-content">
-            <form class="s-form" method="POST" action="/request">
-              <%= Rack::Csrf.csrf_tag(env) %>
-              <fieldset>
-                <label for="email">Email</label>
-                <input class="big" name="email" required type="email">
-              </fieldset>
-
-              <fieldset>
-                <label for="fullname">Full name</label>
-                <input class="big" name="fullname" required type="text">
-              </fieldset>
-
-              <fieldset>
-                <label for="company">Company (Optional)</label>
-                <input class="big" name="company" type="text">
-              </fieldset>
-
-              <fieldset>
-                <label for="reason">Why would you like to use the Protected Planet API?</label>
-                <textarea name="reason" required></textarea>
-              </fieldset>
-
-              <button class="big-button" type="submit">
-                <i class="fa fa-paper-plane big-button__icon"></i>Submit request
-              </button>
-            </form>
+            <%= erb "request/_form".to_sym %>
           </div>
         </div>
       </div>
diff --git a/web/views/request/_form.rhtml b/web/views/request/_form.rhtml
new file mode 100644
index 0000000..448c514
--- /dev/null
+++ b/web/views/request/_form.rhtml
@@ -0,0 +1,59 @@
+<form class="s-form" method="POST" action="/request">
+  <%= Rack::Csrf.csrf_tag(env) %>
+  <fieldset>
+    <label for="email">Email</label>
+    <input class="big" name="email" required type="email">
+  </fieldset>
+
+  <fieldset>
+    <label for="fullname">Full name</label>
+    <input class="big" name="fullname" required type="text">
+  </fieldset>
+
+  <fieldset>
+    <label for="company">Company (Optional)</label>
+    <input class="big" name="company" type="text">
+  </fieldset>
+
+  <fieldset>
+    <label for="kind">Type of User</label>
+    <span class="form__select-container">
+      <select class="big" id="kind" name="kind">
+        <option disabled selected value>Select an option</option>
+        <option value="Scientific Research">Scientific Research</option>
+        <option value="Private Sector">Private Sector</option>
+        <option value="Conservation Organisation">Conservation Organisation</option>
+        <option value="Government">Government</option>
+        <option value="Education">Education</option>
+        <option value="Other">Other</option>
+      </select>
+    </span>
+  </fieldset>
+
+  <fieldset>
+    <label for="has_licence">Do you have a licence to use the API?</label>
+    <span class="form__select-container">
+      <select class="js-licence-select big" id="has_licence" name="has_licence">
+        <option disabled selected value>Select an option</option>
+        <option value="Yes">Yes</option>
+        <option value="No, but I would like to test the API before requesting a licence">No, but I would like to test the API first</option>
+        <option value="No, but I would like to request one">No, but I would like to request one</option>
+      </select>
+    </span>
+  </fieldset>
+
+  <fieldset class="u-hide js-licence-input">
+    <label for="licence_number">Licence number</label>
+    <input class="big" name="licence_number" type="text">
+  </fieldset>
+
+  <fieldset>
+    <label for="reason">Please provide a brief description on how you intend to use the API</label>
+    <textarea placeholder="e.g. who is the audience, what type of service is being provided, how will the data be used: visualisation only, download, reposting" name="reason" required></textarea>
+  </fieldset>
+
+  <button class="big-button" type="submit">
+    <i class="fa fa-paper-plane big-button__icon"></i>Submit request
+  </button>
+</form>
+