Vendor Registration Form

Registration

Username*

Email*

First Name

Last Name

Store Name*

https://medicalmall.com.gh/vendor/[your_store]

Address 1*

Address 2

Country*

City/Town

State/County

Postcode/Zip*

Store Phone*

Verification Document*

Selected ID Number*

Upload Scanned Image of ID*

Password*

Confirm Password*

* Agree  Terms & Conditions