Member Register - Divmart Pos

Sponser Id:

Member Amount:*

First Name:*

Last Name:*

Email:*

Password:*

Contact Number:*

Altnate Contact Number:

Permanent Address:*

Current Address:

ID proof name:*

ID proof number:*

Upload Identity Proof:* Note: Only allow JPG, JPEG and PNG files.

Upload Address Proof:* Note: Only allow JPG, JPEG and PNG files.

Account Holder's Name:*

Account Number:*

Bank Name:*

Bank Identifier(IFSC) Code:*

Branch Name:*

Divmart Pos