Vender Registration

SECTION I : Personal Data & Tax Data (Important Data) -

Vender Name *

Address Line 1 *

Address Line 2

Address Line 3

Postal/Zip Code*

City*

State / Region*

Country*

Email*

Contact Person Name*

Phone

Contact Person Mobile*

Contact Person Email*

Are you related to any employee, officer, director or Committee member of MCA*

PAN No*

WCT Number

Date of Brith / Date of Incorporation *

Form of Company *

SECTION II BANKING all fileds are mandatory -

Payment Mode *

Beneficiary Name*

Type of Account*

Account No *

IFSC Code *

Bank Name *

Branch Address *

Meghalaya Cricket Association

J N Stadium Sports Complex Polo Ground Shillong – 793001
Email:meghalayacricket11@gmail.com

Phone: MCA Office – 0364-2592110
Mr F. Wann, Office Assistant, 087944 35755

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Meghalaya Cricket Association

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