CLIENT/ AGENT REGISTRATION

General Details
Client\Agent ID:
Name: *
Client Type: *
Physical Address
Street Name: *
Street Number:
Physical Code:
Town: *
Country: *
Postal Address
P. O. Box: *
Postal Code: *
Town: *
Country: *
Contact Information
Telephone No: *
Fax No:
E-Mail: *
Contact Person: *
Other Information
VAT No:
PIN No: *
Seed Merchant Reg. No:
Background Info: