Retailer Application Form
This is LoadCentral's official application form.
Notes: Your account registration will be processed within one (1) to three (3) working days. Upon registration, you will receive an SMS and e-mail sent to your provided contact details. Please ensure that all your contact details are CORRECT to avoid non-receipt of notifications.
Please note that LoadCentral's operating hours (Sales and Marketing) are from 9AM to 6PM Mondays to Fridays, except holidays.
N/A if none
Please input your complete address.
Should be active. LoadCentral representative will contact you thru this e-mail address.
Should be active. LoadCentral representative will contact you thru this mobile number.
Mobile Number to register
Account can be accessed thru internet and your mobile phone.
We are committed to your privacy. LoadCentral will only use the information you have provided to send you our marketing and/or promotional offers and for updates regarding new services and products. You may unsubscribe from our SMS notifications and or to our email service by calling our Customer Service Hotline or email us at
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service