SS Telecoms | Dealer Registration Form

Dealer Registration Form

SS Telecoms Head Office
Unit 31B, 10 Monte Carlo Crescent
Kyalami Business Park
Midrand, 1684
Phone: +27 12 664 4644
Fax: +27 86 614 5625

DEALER REGISTRATION FORM

Type of Company

Other Business: Please Specify

Full Company Name

Trading Name

Registration Date

Registration No

Contact Number

Website URL

Nature of Business

Sales Person Contact

Physical Address

Postal Address

Phone

ID Number of Owner/Partner/Director/Members

Full Name of Owner/Partner/Director/Members

ID Number of Owner/Partner/Director/Members

Full Name of Owner/Partner/Director/Members

Cell number for SMS payment confirmations

Primary Contact Person Name

Primary Mobile Number

Primary Email Address

Accounts Name

Accounts Contact Number

Accounts Email Address

Buyer Name

Buyer Contact Number

Buyer Email Address

Product and Marketing Information Name and Email

Which other trade suppliers are you registered with

How did you find us?

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