How can we get in touch?

First Name

Last Name

Email

Phone Number

Mobile Number

Company Name

Describe your business category

Website( e.g yourcompany.com)

Social Media

Are You VAT Registered? Are You VAT Registered? Yes No

Monthly Revenue Monthly Revenue Less than R20k R20k - R50k R50k - R100k R100 - R500k More than R500k

Business Registration Number

Business Owner First Name

Business Owner Last Name

Business Owner Email Address

Number of Unique Products

What brands or products do you carry?

Do you carry stock? Do you carry stock? Yes No

Do you have a physical store? Do you have a physical store? Yes, I have a store No, I sell through other channels

Are you a supplier to retail outlets? Are you a supplier to retail outlets? Yes, I supply retail outlets No, I sell through other channels

Have you had a registered account? Have you had a registered account? Yes No I worked on someone else's seller account

Do you have any additional comments?