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Display Name

ie: Star Ice Cream (maximum 40 character)

the Banner Number

Registration Number

i.e. Nomor Induk Berusaha (NIB)

Description

ie: We are the sweetest Ice Cream in Town. Once You Try, Forever in Love (maximum 80 characters)

Color

ie: #ffffff for white (hex color code)

Banner

Click or drag a file to this area to upload.

Dimension: 1440 x 448 pixel

Logo

Click or drag a file to this area to upload.

Dimension: 224 x 224 pixel

Primary Phone Number

Label for Primary Phone Number

i.e: hotline

Primary Website/URL

Label for Primary Website

Privacy Policy URL

Terms of Services URL

Details about the brand that the agent represents. This information may be shared with carriers for the purpose of receiving launch approval.

Legal Name of The Brand's Parent Company

Website of The Brand's Parent Company

Name of the Brand Employee

Title of Brand Employee

Phone

Email