Membership Form

Delited to see you're interested in working with us. We hope this will be the beginning of a long term business relationship. The form below contains personal, account, workplace and the "You and Paksaman" sections. Please fill up each section and note that all fields are mandatory except customer code filed.

Contents of this form are confidential and won't release to any third party.

Like you we don't enjoy long forms, but sometimes for speeding up the registeration precess, long forms are required. We appericate the time you took to fill this form up, in advance.

Contents of this form are confidential and won't release to any third party.

1

Personal Info

Please enter your name, surename and cell phone number. Note that we won't send any advertising text messages.

3

Workplace Info

Please complete all fileds, in order to facilitate delivery preocess please enter the postal code accurately.

4

You and Paksaman

If we've been business partners before please enter how many years of cooperation we have.

Please check the marked fileds again, note that all fields except the customer code field are mandatory.

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