Vendor Registration

Username*

Username*

Email*

Email*

First Name

First Name

Last Name

Last Name

Address 1*

Address 1*

Address 2

Address 2

Country*

Country*-Select a location-Sri Lanka

City/Town

City/Town

State/County

State/County

Postcode/Zip*

Postcode/Zip*

Store Phone*

Store Phone*

NIC*

NIC*

Your Photo*

Your Photo*

Preferred Bank Name*

Preferred Bank Name*

Account Number*

Account Number*

Branch Code and the Branch*

Branch Code and the Branch*

Photo*

Photo*

Password*

Password*

Confirm Password*

Confirm Password*

* Agree  Terms & Conditions