Email Address:
Email Format:
Required Your email address is your user name.
Re-Enter Email Address:
Required
Password:
Required
Security Question:
Required Choose one. This question will be used to verify your identity should you forget your password.
Answer to Security Question:
Required
Participant Name: (e.g. East Side Winery, Gin Brothers etc.)
Required
Name and Surname of Contact Person:
Required Please enter only one person's name.
Contact Number for Contact Person:
Website address:
Facebook address:
Instagram address:
Hashtags most often used on social media:
Details exactly how it will appear on the Tax Invoice
Company name as it will appear on the Tax Invoice:
Street Address:
Suburb:
City:
Postal Code:
Province:
Western Cape
Eastern Cape
Free State
Gauteng
Kwazulu Natal
Limpopo
Mpumalanga
Northern Cape
VAT#: (NA if not applicable)
Country:
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Details of the person, and address where stickers should be couriered:
Tick here if Shipping Address same/similar to Billing Address
Company that will receive the stickers:
Name and Surname of Contact Person:
Required Please enter only one Person's name.
Contact Number for Contact Person:
Email address of Contact Person:
Street Address:
Suburb:
City:
Postal Code:
Province:
Country:
Special Instructions:
Name of person in charge of payments:
Phone number of person in charge of payments:
Email address of person in charge of payments:
Company Logo upload (optional)
Please upload your company logo with dimensions 1080 x 1080 pixels (optional).
