Full Name:

Owner Name:

Business / Company Name:

Registered Business Address:

Website:

Select the Website's Business Category:

 Computers, IT Equipment and Software
 Domain Registration / Web Design
 Entertainment and Recreation
 Games / Toys / Gifts / Miscellaneous
 Industrial Tools and Equipment
 Medical and Health Services     
 Travel / Ticketing / Hotel Reservations / Car Rental
 Building and Interior Design
 Education.
 Finance, Law, Accounting and Other Consulting
 Vehicles and Spare Parts
 Communication Equipment / Cameras
 Fashion / Clothing / Accessories
 Food and Beverages
 Arts and Culture
 Equipment, Tool and Engine Rental
 Everyday Consumer Goods
 News / Media / Advertising
 Furniture and Furnishings
 Sports / Recreation Equipment
 Construction Materials / Tools / Equipment
 Other Businesses

Business Activities (Expand on Item 5: what goods or services does your website trade?):

 Retail Sales
 Wholesale Sales
 Service
 Internet Service Provider (ISP)
 Web Hosting
 Online Marketplace for Goods or Services 

Reservation / Ordering System Used:

 Shopping Cart
 Order Form
 E-mail
 Phone.
 Fax
 Other

Payment Method:

 Offline Payment (Bank Transfer, Postal Payment, Payment to Staff, etc.)
 Online Credit Card Payment 
 Online Banking Payment 
 Online Payment through Providers such as PayPal or Paysbuy 
 Other

Delivery Method:

 Shipping Company
 Postal Service
 Delivery Staff
 Download
 E-mail 
 Other

Capital Invested in E-Commerce:

Mobile Phone Number:

Fax Number:

Email:

Manager's Name:

Registered Office: