Load Central Registration and Simcard Activation Request Form
Step 1: Fill in the following fields then click the submit button.  
Step 2: Send a scanned copy of your valid I.D. to fmfjr2010@gmail.com (It must be back to back and unexpired).  
Note: Incomplete and/or inappropriate details will nullify your registration and that simcard activation will no longer be processed, Thus, barring you permanently from making any future requests.
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Complete Name: First Name |  Middle Initial | Last Name *
Example: Juan D. Cruz
Birth Date *
Example: mm/dd/yyy 08/30/1986
Cellphone Number To Register *
Example: 09181234567
Valid E-Mail Address *
Complete Address *
Do you want to receive newsletters and updates to your mailbox? *
Required
By clicking the submit button, you hereby certify that [1] the information(s) you have provided is true and correct, thus reflecting your real identity [2] that the information(s) you have provided matches to any of your Valid I.D.'s which is required prior to processing of your request for registration and simcard activation. [3] that the cellphone number you are trying to register has not been registered yet to other dealer(s)/sub-dealer(s) of Load Central. You certify further in good faith that you really intend to become an active Load Central Retailer. WARNING: Your I.P. Address is being monitored. *
Required
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