Registration - OTPro Marketplace

First Name *

Last Name *

Company Email *

Username *

Company Phone Number *

Secondary Contact Name

Secondary Contact Email

Business Name *

Company Registration Number *

Business Description

Business Type *

Shop Name *

Shop URL * Your store URL will be: example.com/shop/

Address

Street *

Street 2

City *

Post/ZIP Code *

Country *

State

What is your BBBEE level? *

BBBEE Certificate Expiry Date

Is your organization Black Owned? *

Is your organization Black Women Owned? *

Is your organization Designated Group Owned? *

Is your organization in a state of bankruptcy or insolvency? *

Has your organization been convicted of a criminal offence related to business conduct? *

Has your organization committed an act of grave misconduct in the course of business? *

Has your organization not fulfilled obligations related to payment of taxes? *

Is your organization guilty of serious misrepresentation in supplying information? *

Is your organization not in possession of relevant licenses where required by law? *

Has your organization committed any act of bribery and corruption? *

If the answer to any of these questions is 'Yes', please give brief details: