Supplier Sign Up Form
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Username
*
Required. 150 characters or fewer. Letters, digits and @/./+/-/_ only.
Email address
First name
Last name
Password
*
Your password can’t be too similar to your other personal information.
Your password must contain at least 8 characters.
Your password can’t be a commonly used password.
Your password can’t be entirely numeric.
Password confirmation
*
Enter the same password as before, for verification.
Company name
*
Propitory name
*
Date of birth
*
Propitory nid no
*
Propitory nid attachment
*
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File size should be less than 2MB with .pdf extension
Photo
*
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File size should be less than 1MB with .jpg .png .jpeg extension
Trade license no
*
License attachment
*
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File size should be less than 2MB with .pdf extension
Tin no
*
Tin attachment
*
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File size should be less than 2MB with .pdf extension
Vat registration no
*
Vat registration attachment
*
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File size should be less than 2MB with .pdf extension
Address
*
Company phone no
*
Company email
*
Nominee name
*
Nominee address
*
Nominee nid no
*
Nominee nid attachment
*
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File size should be less than 2MB with .pdf extension
Nationality
*
Captcha
*