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Halal Delivery Partner Signup Form
Sign up below to join the Halal Delivery platform, and our staff will contact you to discuss further!
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* Indicates required question
Email
*
Your email
Restaurant or Business Name
*
Your answer
Restaurant or Business Address
*
What is your pickup or delivery address?
Your answer
City where your Restaurant or Business is located?
*
What city is your restaurant or business located?
Your answer
What State is your Restaurant or Business located?
*
Your answer
Restaurant or Business Zip Code
*
Your answer
Restaurant or Business Phone Number
*
Your answer
Restaurant or Business Fax Number
Your answer
Your First Name
*
Your answer
Your Last Name
*
Your answer
Email Address
*
Your answer
A copy of your responses will be emailed to the address you provided.
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