Application
Documents
Confirmation
Payment
Acknowledgement
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Application for Accreditation of Provider
Note: All Fields marked with asterisk (
*
) are mandatory.
Provider Information
*
Provider Type
Accredited
*
Organisation Type
--Select Here--
Ministry / Statutory Board
Private
Professional Institution
Restructured Institutions
Retail
Societies
Universities
Others
*
Organisation Type (Others)
For Organisation Type (Others), please specify the following information:
*
Paid-up Capital
*
Year of Establishment (yyyy)
*
Registered as
--Select Here--
Private
Private Limited
Publicly Listed Company
*
Majority Owned by
--Select Here--
Foreign Investor
Local Investor
*
Organisation
--Select Here--
*
Organisation (Others)
Department / Ward
--Select Here--
*
Department / Ward (Others)
Website URL
Additional Remarks
Provider Address
*
Postal Code
Block/House No.
Level - Unit No.
-
Street Name
Building Name
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Maximum number of 100 Account Holders was reached.
Account Holder Details
Name
Designation
Email Address
Role
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