CLIENT/ AGENT REGISTRATION

General Details
Client\Agent ID:
Name: *		*
Client Type: *		*
Physical Address
Street Name: *		*
Street Number:		Must be a Number
Physical Code:
Town: *		*
Country: *		*
Postal Address
P. O. Box: *		*
Postal Code: *		*
Town: *		*
Country: *		*
Contact Information
Telephone No: *		* Must be a Number
Fax No:		Must be a Number
E-Mail: *		* Invalid E-Mail
Contact Person: *		*
Other Information
VAT No:
PIN No: *		*
Seed Merchant Reg. No:
Background Info: