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Retailer Registration Form

Dear Sir,
Please fill in the form and return it by hand, by post or email.
Address:
DM-55, Khayaban-e-Rahat, Street # 34, Phase VI, DHA, Karachi, Pakistan
Tel: +92 (21) 3534 0022-24
Fax: +92 (21) 3535 0393
Email: bookshop@quranacademy.com
Web: www.QuranAcademy.com
Please attach the following documents:
Visiting Card
Owners Copy of CNIC
Company/Shop Name: ___________________________________________________
Company/Shop Address: _________________________________________________
_____________________________________________________________________
Contact Person: ________________________________________________________
Address: ______________________________________________________________
_____________________________________________________________________
Telephone: ________________________

Mobile: ___________________________

Fax: ______________________________

Email: ____________________________

Website: _________________________
What content do you want to sell?
CDs/DVDs
Books
Both

How do you sell your products?


Online Store
Both

In case of cooperation between your company and Quran Academy, do you want
your contact details to be published on our website?
Yes
No

Date: _____________

___________________
Signature of contact person

__________________
Company Stamp

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