Vendor Registration

Email*

Store Name*

https://www.visatcomputeracademy.com/maapack/store/[your_store]

GENERAL DETAILS :

Name*

Address HO*

City*

Pincode*

State*

Country*

Phone No 1*

Phone No 2*

Contact Person*

Designation*

Mobile No*

Email

Website

CompanyType*

BusinessType*

SSI / MSME Lic No.

PAN No.

PAN Name

GST No.

Trade Name

BILLING DETAILS :

Name*

Address*

City*

Pincode

State*

Country

GST No.

Contact Person*

Mobile No*

SHIPPING DETAILS :(if other than billing details)

Name*

Address*

City*

Pincode

State*

Country

GST No.

Contact Person*

Mobile No*

CONTACT MATRIX :

Purchase Department

Name of Contact Person

E - Mail ID

Contact No.

Technical Department

Name of Contact Person

E - Mail ID

Contact No.

Account Department

Name of Contact Person

E - Mail ID

Contact No.

Other Department

Name of Contact Person

E - Mail ID

Contact No

DOCUMENT TO BE SUBMITTED :

Pan Card

GST Certificate

Certificate of Incorporation

SSI /MSME Licence

MOA & AOA

Partnership Deed

Address Proof of Branch / Works

IE Code (For, Overseas Customer)

DECLARATION :

We hereby declare that the information furnished and true to the best of our knowledge. We agree that rendering false information in the application shall debar us for enlistment with AEROLAM in future.

Place

Date

FOR OFFICE USE ONLY

Customer Code :

Credit limit:

Name of Sales Person :

Payment Terms :

Remarks :

Password*

Confirm Password*