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Financial Institution Registration

* marked are required fields

General Information
Insitution Name *:
Insitution Type :
District / Region *:
Location / Area *:
Contact Tel Number *:
(Use comma for separting more than one contact numbers)
Fax Number :
Contact Name *:
Email Address *:
(This is the corresponding email address)
Notification Email *:
(This is the email address where enquiries will be sent to)
Logo (<500KB):
(Best Fit Size: 140px x 110px & Size limit less than 500 Kb)
Account Details
Choose a password*:
Re-enter the password*:
In order to help us prevent automated submissions, please type the number shown in below picture
Validation no.*:
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