Agent Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Phone (Optional) been Referrer (Optional)Name *FirstLastPhone Numbers *Email (Optional)Business Name *Business Type *Business Address *City/Town *How long have you been doing remittance ? *SelectLess than 6 Months6 Months - 1 Year1 Year - 2 Years2 Years - 4 YearsAbove 4 YearsNumber of Branches / Subagents Selected Value: 1 Projected Monthly Turnover (NLE) *Please enter the amount you expect to be your minimum turnover per monthSubmit Request
