Vendor Registration

Email*

Email*

First Name

First Name

Last Name

Last Name

Address 1*

Address 1*

Address 2

Address 2

Country*

Country*-Select a location-Brunei

City/Town

City/Town

State/County

State/County

Postcode/Zip*

Postcode/Zip*

Store Phone*

Store Phone*

Business License Copy

Business License Copy

Owner IC Copy*

Owner IC Copy*

Bank Account Details

Bank Account Details

E-shop Manager IC Copy*

E-shop Manager IC Copy*

E-shop Manager Name

E-shop Manager Name

E-shop Manager Mobile No*

E-shop Manager Mobile No*

Password*

Password*

Confirm Password*

Confirm Password*

* Agree  Terms & Conditions