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Know Your Customer Form
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How did you find us?
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Facebook
Instagram
Refer from a friend
Internet Search
Other:
First Name
*
Your answer
Surname
*
Your answer
Name of Business
*
Your answer
Please add your Social Media Business Page (Instagram / Facebook)
*
Your answer
What category does your business fall into? (please check ALL that applies to you)
*
Fashion / Clothing / Accessories
Beauty / Cosmetics
Tech / Electronics
Food
Agriculture
Transport
Education
Pharmaceutical
Other Retail
Other:
Required
Email
*
Your answer
Phone number
*
Your answer
Pick Up Address (please list ALL addresses we may have to pick up from)
*
Your answer
Banking Information (if we need to reconcile any payments received on your behalf). Please include; Full Name on the Account, Bank, Branch, Bank Account Number, Bank Account Type
Your answer
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