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Email*

First Name

Last Name

Store Name*

https://www.cleantech-mart.com/store/[your_store]

Address 1*

Address 2

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Postcode/Zip*

Store Phone*

Aadhar card Number*

Upload Aadhar Card Image (Front)*

Upload Aadhar Card Image(back)*

Shop License Number*

GSTIN*

Referal Code

Password*

Confirm Password*

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