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SUPPLIER REGISTRATION FORM
Supplier Name
Product / Service Offering
CONTACTABLE BUSINESS REFERENCE
Company
Scope of Work
Value of Services Rendered
Contact Name
Contact Number & Email Address
COMPANY INFORMATION
Registered Company Name
Company Registration Number
Registered Company Address
CIPC Document
Upload File
Upload supported file (Max 15MB)
Phyical Address
Office Phone Number
Website
VAT Number
Tax Clearance Certificate
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Upload supported file (Max 15MB)
Bank
Account Holder Name
Account Type
Account Number
Branch
Branch Code
Bank Confirmation Letter
Upload File
Upload supported file (Max 15MB)
BEE Level
Black Shareholding %
Female Shareholding %
Black Female Shareholding %
BEE Certificate / Affidavit
Upload File
Upload supported file (Max 15MB)
SERVICE REQUESTS
Contact Name
Designation
Email Address
Contact Number
Notice Required (if applicable)
SERVICE-RELATED QUERIES
Contact Name
Designation
Management Level
Email Address
Contact Number
ACCOUNTS CONTACT
Contact Name
Designation
Email Address
Contact Number
INVOICE TERMS & PAYMENTS
Billing Currency
Invoice Terms
Select
Preferred Payment Reference
Select
Email Address for Remittance Advices
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