Fill in the form below to register as a dealer. HiddenNext Steps: Install the User Registration Add-OnThis form requires the Gravity Forms User Registration Add-On. Important: Delete this tip before you publish the form.Name(Required) First Last Phone Number(Required) Business DetailsBusiness Name(Required) Business Location(Required) Business Incorporation Documents(Required)Upload documents such as certificates of incorporation.Max. file size: 10 MB.Business Registration Documents(Required)Upload documents such as CR12.Max. file size: 10 MB.KRA PIN(Required)Upload the business' KRA PInMax. file size: 10 MB.Director DetailsEnter the details of one business directorName(Required) First Last Phone Number(Required) Email(Required) National ID / Passport(Required)Upload the director's national ID or passport.Max. file size: 10 MB.Dealer Account DetailsYou will use these details to login to your dealer account.Email(Required) Enter Email Confirm Email Password(Required) Enter Password Confirm Password NameThis field is for validation purposes and should be left unchanged.
