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The Ujamaa Network

EMPOWERING PEOPLE WITH OPPORTUNITY

Partner Registraton

NOTE: If you already have an account with us, please login at the login page.

Gender:   Male    Female *
First Name:  *
Last Name:  *
Date of Birth:  * (eg. 05/21/1970)
E-Mail Address:  *
SSN Number  * (eg. 273-42-6389)

Company Details

Company Name:  
Business name:  *
Business type:  *
Federal Tax ID Number:  * (eg. 13-4263891)
How many years established:  *
Type of Products:
Number of employees:
Average sale item price tag:
Average sales per month:

Your Address

Street Address:  *
Zip Code:  *
City:  *
State/Province:  *
Country:  *

Your Contact Information

Telephone Number:  *
Fax Number:  
Business Number:  *
Alternate Number:

Your Password

Password:  *
Password Confirmation:  *
Partnership Agreement:  *
  Click to read complete Agreement.

I agree to the Partnership Agreement.