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First Name *

Last Name *

Login Username *

Email *

Confirm Email *

Vendor Name * Important: This is the name that customers see when purchasing your products. Please choose carefully.

Telephone Number *

Please describe something about your company and what you sell. *

Display this description in your public vendor profile (Can be edited later)

Full Address *

Agent Code If you were referred by agent, enter the agent code provided. Leave out if not applicable.

Account holder Name *

Account Number *

Account Type * Select Savings Cheque Current

Bank Name * Select Absa Group Limited African Bank Limited Bidvest Bank Limited Capitec Bank Limited Discovery Limited First National Bank FirstRand Bank - A subsidiary of First Rand Limited Grindrod Bank Limited Imperial Bank South Africa Investec Bank Limited Mercantile Bank Limited Nedbank Limited Sasfin Bank Limited Standard Bank of South Africa Ubank Limited TymeBank

Branch Name *

Branch Code *

Terms and Conditions* I have read and accept the Terms and Conditions