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Registration Form

Fields marked with * are necessary

Company Name *

Address / P.O.Box *

Address 1 *

Address 2 *

City *

State

Post Code / Zip Code :

Country *

Physical Location / Landmark :

Building Name :

Office Number :

Company Registration No.

Tel *

(Please include country & city code)

Fax*

(Please include country & city code)

Company Email : *

Web :

GPS co-ordinates :

GPS Longitude	GPS Latitude

Office Hours :

Categories* :

Category 1

Category 2

Category 3

Category 4

Category 5

Key Personnel :
Please enter upto 5 contacts
( Tel & Email optional,5 lines )

Key Persons 1

Name *
Designation *		Job Function *
Tel *		Email *
Brand

Key Persons 2

Name
Designation		Job Function
Tel		Email
Brand

Key Persons 3

Name
Designation		Job Function
Tel		Email
Brand

Key Persons 4

Name
Designation		Job Function
Tel		Email
Brand

Key Persons 5

Name
Designation		Job Function
Tel		Email
Brand

Activities :
( in running text )

Quality Assessment :
( Quality assesment or credentials, 5 Lines, 40 Charactors each line )

Branches :
( Please include country & city code for Tel & fax Numbers )

Branch 1

Branch Name	P.O. Box / Address 1

City	Address 2

Telphone	Fax

Branch 2

Branch Name	P.O. Box / Address 1

City	Address 2

Telphone	Fax

Branch 3

Branch Name	P.O. Box / Address 1

City	Address 2

Telphone	Fax

Branch 4

Branch Name	P.O. Box / Address 1

City	Address 2

Telphone	Fax

Branch 5

Branch Name	P.O. Box / Address 1

City	Address 2

Telphone	Fax

Year Established :

(Ex: 1948)

Banker Name :

No. of employees :

Turnover :

Credit Rating :

Information Filled By # *

Name:

Email:

# You will receive a conformation on submmission on above email address.

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