REGISTRATION


Please send us attached file to this address 　　
co-op@gowell.co.jp

BUSINESS REGISTRATION FORM

Reg.No.                                  ApplicationDate Y/M/D:        /    /

Company 
Name

  

Web-shop
Name

  

CompanyAddress

  

WebMasterName

  

Representatives

  

CompanyName

  

BusinessTitle

  

CompanyAddress

  

StoreNameAddress

      

TEL

FAX

URL

e-mail

  

TEL

FAX

ShopURL

e-mail

  

ContactPerson&e-mail

  

ContactPerson & e-mail

  

Business

Status

wholeseller, retailer

web-shop, complexed

    

Initiation

  

Start up

  

Capital

      

Sales

Amount

  

Sales Amount

  

Bank name

Branchname

AccountNo.

  

Bank name

Branch name

Account No.

  

Number of

employee

  

Number of

Employee

  

Your Brand

  

Your Brand