Small Business Open Market by Aquada
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Name
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Application Form
Title
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Mr.
Mrs.
Ms.
First Name
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Middle Name
(optional)
Last Name
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Phone I
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Phone II
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Phone III
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Email I
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Email II
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Position in Organization
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Company/Organizational Information
Name of company/organization
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Type of business
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Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC)
Cooperative
Company Phone I
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Company Phone II
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Company Phone III
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Company Email I
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Company Email II
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Company Address I
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Company Address II
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City
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State/Province
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Postal/Zip Code
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Country
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Role of Organization
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Marketer
Distributor
Processor
Farmer
Farmer Group
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Year Company Started Operations
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Head of Organization
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Mr
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Ms
First Name
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Middle Name
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Last Name
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RC Number (Registered Business)
(optional)
Company's Facebook
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Company's Whatsapp
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Company's Twitter
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Company's Instagram
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Products & Services
Products organization can supply
*
Beans
Fresh Cassava
Cassava (Bitter)
Cassava (Sweet)
Cassava Flour
Dry Cassava Chips
Corn (White)
Corn (Yellow)
Groundnut
Rice Bran
Rice Paddy (Short grain)
Rice Paddy (Long grain)
Sesame Seed (Yellow)
Sorghum (Red)
Starch Flour
Yam
Wood Shavings
Waste Plastic
Monthly Supply Capacity (Metric Tonnes)
Beans
(optional)
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98
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100
Fresh Cassava
(optional)
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100
Cassava (Bitter)
(optional)
1
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98
99
100
Cassava (Sweet)
(optional)
1
2
3
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5
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Cassava Flour
(optional)
1
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100
Dry Cassava Chips
(optional)
1
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Corn (White)
(optional)
1
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100
Corn (Yellow)
(optional)
1
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98
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100
Groundnut
(optional)
1
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96
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98
99
100
Rice Bran
(optional)
1
2
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100
Rice Paddy (Short grain)
(optional)
1
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Rice Paddy (Long grain)
(optional)
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100
Sesame Seed (Yellow)
(optional)
1
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5
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98
99
100
Sorghum (Red)
(optional)
1
2
3
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5
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8
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86
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91
92
93
94
95
96
97
98
99
100
Starch Flour
(optional)
1
2
3
4
5
6
7
8
9
10
11
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100
Wood Shavings
(optional)
1
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5
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Yam
(optional)
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98
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100
Waste Plastic
(optional)
1
2
3
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5
6
7
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10
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