Fill Company Information
Firm/Company Name* :

Office Timing * :

Address :

Contact Person * :

Contact No.*

Email id *

Dealing in * :

Discount To Be Offered
Up to 500 :

501 Up to 1500 :

1501 and Above

Or
:

Fixed discount* :

Associate Till* :

Minimum Pay* :

Any Other Benefits :

Declaration : I/We here by confirm that we shall be associated with Connect2Deal for a period as stated aforesaid & shall provide discount to all the users of connect2deal as specified here.
Date :
Place :