Register

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

How many Branch/es you want to add in directory. First three location are included in anual fees(s). Extra locations are $10 each. Leave it blank if No Branch

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 2

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 2

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 3

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 2

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 3

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 4

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 2

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 3

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 4

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 5

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 1

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 2

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 3

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 4

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 5

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Branch 6

Company Name*
Company Address*
Mailing Adress
Telephone*
Fax
Email Address*

Contact Person*	Mobile Phone No.*	Tel No.

A brief description of your company's products/services(Maximum of 100 words)*

My Business should be listed under the following category*

To select 2 or more categories Press Ctrl+Click category your want to select.

Have you included your company logo(Letterhead, Brochure)*?

Yes
No

FEE PAID	Extra Location(s) $10 per location.	Total:
1 year-350 2 Years-$550

Payment Mode

Collection

cheque

A/C Payee To HSBC a/c 001-286640001

I have completed this form and I agreed that the information above is correct.*

Email Address*