Manufacturer Registration Form

1
  Organisation Details
Note











2
  Brand Information Details
Note: A copy of the brand registration certificate must be sent to the RB when requested.
3
  Contact - Primary
Title [Optional] : Mr Miss Mrs Ms Dr

Contact - Secondary
Title [Optional] : Mr Miss Mrs Ms Dr

4
  Business Q & A

Yes No

Yes No

Yes No

Yes No
Yes No
5
  Additional Information
Note: Provide any additional information that might be helpful.