Loita Business | Registration

Contact Information

Contact Name^*

Designation^*

Gender^*

Nationality^*

Email Address^*

Contact Number (Mobile)

Contact Number (Office)

Contact Address Details

Address Line 1^*

Address Line 2

Country^*

Province^*

City

Suburb^*

Postal Code^*

Business Details

Company Name^*

Incorporated and registered under the laws of^*

Company Website

I want to register as^*

Company Registration Number^*

Company Vat (Tax) Number

Sector^*

Business Type^*

currency^*

Annual Revenues^*

Monthly Sourcing Volumes^*

Are You an Importer?^*

Are You an Exporter?^*

Total Number Of Employees^*

Key Objectives for joining Loita Business^*

Is your company buying on any B2B Marketplace Platform?^*

Account plan^*

Business Address Details

Address Line 1^*

Address Line 2

Suburb^*

Business Country^*

Province^*

City

Postal Code^*

Business Contact Details

Primary Contact Person^*

Primary Contact Number^*

Primary Contact Email Address^*

Funding Requirements

Do you require any trade, supply chain or investment financing?^*

Capital sought^*

Nature of Facility^*

Facility Amount^*

Facility Purpose^*

Please indicate if you have security for the requested Facility^*

Description of facility request and amount for which approval should be sought; in clear and unambiguous terms.^*

Terms and Conditions.

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I agree to the Terms and Conditions^*