Registration Form

Business Name : Phone # :
Owner First Name : Cell # :
Owner Last Name : Email :
Sales Contact Name : Website :
Account Contact Name :    
Business Address :
City :    
Business Information (Products & Services Offering) :
Year Started : No. of employees :
Annual Turnover (Pak Rs.) :    
Banker : Branch Name :
Sales Reference 1 : Contact # :
Sales Reference 2 : Contact # :

CONFIDENTIALITY STATEMENT

This application, and any information pertaining to it, is confidential and shall not be passed to any third party, without the express permission of the applicant.

DECLARATION

I confirm that, to the best of my knowledge, the information that I have supplied in this application is true and accurate.

Signature Name : Date :