Distributor Registration
Submit your distribution business details for Head Office approval.
Login
Business Name
Contact Person
Email
Mobile Number
Password
Minimum 8 characters including uppercase, lowercase, number and special character.
Confirm Password
District
Select district
Bajali
Baksa
Barpeta
Biswanath
Bongaigaon
Cachar
Charaideo
Chirang
Darrang
Dhemaji
Dhubri
Dibrugarh
Dima Hasao
Goalpara
Golaghat
Hailakandi
Hojai
Jorhat
Kamrup
Kamrup Metropolitan
Karbi Anglong
Kokrajhar
Lakhimpur
Majuli
Morigaon
Nagaon
Nalbari
Sivasagar
Sonitpur
South Salmara-Mankachar
Sribhumi
Tamulpur
Tinsukia
Udalguri
West Karbi Anglong
PIN Code
Full Address
GST Number
(Optional)
Trade Licence Number
Trade Licence Document
Allowed formats: PDF, JPG, JPEG, PNG.
Business Premises Photo
Upload a clear photograph of your business premises.
GPS Latitude
GPS Longitude
Use Location
Click "Use Location" to capture your current GPS location.
Submit Distributor Registration