Centracom Dealer Application
Login Information
Login Email
*
Invalid value
Validate Email
Error Encountered
Company Information
Legal Company Name
*
Invalid value
Trading As
Registration Number
*
Invalid value
VAT Number
Billing/Postal Address
*
Street Name / Box Number Suburb City Postal Code
Invalid value
Physical Address
*
Street Name Suburb City Postal Code
Invalid value
Contact Information
Primary Contact
*
Invalid value
Telephone
*
Invalid value
Fax Number
Invalid value
Primary Contact Email Address
*
Invalid value
Primary Contact Mobile Number
*
Invalid value
Notifications Email Address
*
Invalid value
Banking Information
Bank
*
Invalid value
Branch Name
*
Invalid value
Branch Code
*
Invalid value
Account Number
*
Invalid value
Account Name
*
Invalid value
Loading…
Show another code
Type the code shown:
The submitted code is incorrect
Submit Application
Cancel
Loading…
Duplicate Company Name
The Company Name you have provided already exists as a Customer or Dealer on the Centracom database
Please contact
support@centracom.co.za
for advice on how to proceed