First Name*
Last Name*
Title*—Please choose an option—Mr.MisMadam
Mobile Number*
WhatsApp Number*
Email Address*
Company Name*
Business Name/Shop Name*
Business Email*
Business Location/Address*
Business Phone Number*
Business Website URL, if any
Opening Hours*
Closing Hours*
Logo Icon/ Business Picture
Store Banner, if any
Business Latitude Location*
Business Longitude Location*
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Delivery Range (in miles)*
Type of your business*Fast FoodRestaurantGrocery StoreFlower ShopSweets Shop
Cuisines served (if Restaurant or Fast Food)AfghaniArabicAsianChineseEgyptianEuropeanIndianIranianIraqiItalianKurdishLebaneseMexicanMoroccanMughlaiNepaliPakistaniSyrianThaiTurkish
Services given*DeliveryPickupDine-in
PayPal ID
Bank Name
Bank Sort Code
Account number
Facebook profile URL
Twitter profile URL
Instagram profile URL
TikTok profile URL
Note: All private info of the subscriber will be saved on a secure system and will not be shared to anyone.
Vendor's Signature(Use your mouse to sign digitally)
Vendor Full Name
Date
Agents's Signature(Use your mouse to sign digitally)
Agent Full Name
I declare that all information is correct & doesn't content any fake information. If any misleading information is found, then a strict legal action will be taken.
I agree with the policies against alcohol & drug abuse.
Centre Eats
Centre Eats