REGISTRATION
FORM
(*All fields
are mandatory) |
Seller Type
* |
|
Address |
User
Type * |
|
Name
of the Organisation/Person:* |
|
Contact
person* |
|
Date
of Birth* |
|
|
|
|
Designation* |
|
Address/Street* |
|
City* |
|
PIN* |
|
State* |
|
Country* |
|
E-Mail* |
|
Phone* |
|
Phone |
|
Phone |
|
Mobile |
|
Fax |
|
Preferred
User Id*( 8-12 characters) |
|
Password*(
8-15 characters) |
|
Confirm
Password* |
|
Sales
Tax Reg. No./VAT No. |
|
Passport
No. |
|
Voter's
ID Card No. |
|
PAN
Card No. |
|
Payment
in Favour of |
|
|
Mailing
Address |
Same As Above
|
Street* |
|
City* |
|
PIN* |
|
State* |
|
Country* |
|
Second
Representative Contact Address |
Name
of the Person |
|
Date
of Birth |
|
|
|
|
Designation |
|
Department |
|
Street |
|
City |
|
PIN |
|
State |
|
Country |
|
E-Mail |
|
Phone |
|
Phone |
|
Phone |
|
Mobile |
|
Fax |
|
Banker
Details |
|
|
Bankers'
Name* |
|
Account
Number* |
|
Branch* |
|
Branch Code |
|
Comment
|
|
Buyer Terms & Conditions
|
Seller Terms & Conditions
|
|
|
I Agree
|
|