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RESELLER ACCREDITATION PERSONAL INFORMATION DATA (RAPID) Registration Form

We are glad to know that you are interested to be a reseller of our Products. Kindly take a few minutes of your time to complete the blanks below. (Natutuwa kaming malaman na ikaw ay interesado na maging reseller ng aming Produkto. Pakisagutan ang mga hinihinging impormasyon sa baba nito.



From whom did you know about our reselling program? (Kanino mo nalaman ang tungkol sa aming reselling program?) *

Siomai House Employee
Siomai House Reseller
OTHERS

Siomai House Social Media

Nearest SIOMAI HOUSE OUTLET (Pinakamalapit na SIOMAI HOUSE OUTLET) *

Full Name (Buong Pangalan)

Gender (Kasarian)

Male
Female

Civil Status (Katayuang Sibil)

Single
Widowed
Divorced
Married
Separated

Citizenship (Pagkamamamayan)

Birthdate (Araw ng kapanganakan)

Place of Birth

Take a selfie

Take a photo of at-least two of your government issued Identification Cards. (Kunan ng larawan ang kahit 2 sa inyong mga government issued ID's) *

Example

Current Home Address (Kasalukuyang Tinitirhan) *

Social Media Accounts *

Mobile Number (Telepono)

Other Contact Number (Ibang numero kung saan pwede matawagan)

Active Email (Email Address na ginagamit)

Other food business name and registration number (SEC/DTI), if any. If online business, kindly provide the link to your website or social media page.

(Pangalan ng iyong Negosyo at Rehistro (SEC/DTI), kung meron man. Kung online business, ibigay ang link sa iyong website or social media page.)

Ex. BUSINESS NAME / SEC or DTI REG # : 88888888
Ex. ONLINE BUSINESS / facebook.com/myonlinestore

Mode of Transportation

Motor
Car
Public Transportation
OTHERS

Cold Storage availability? (Mayroon ka bang malamig na imbakan?)

Freezer/Refrigirator
Ice Box
OTHERS
Styro Box
Thermal Bags

Declaration

I hereby confirm that I have read and understood all the provisions stated in the Basic Instruction Bernabest Livelihood Entrepreneurship (BIBLE) . (https://sites.google.com/view/siomaihousesharebible) . I hereby also confirm that the information provided herein is accurate, correct and complete and the documents submitted are genuine to the best of my knowledge. I undertake to inform Siomai House in writing of any changes to the information already provided and to update the information on this form whenever requested to do so . I further understand that any false, inaccurate or misleading statements may result in denial or revocation of my accreditation as Siomai House reseller. *

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118 D Arellano St., Bagong Barrio, Caloocan City PH NCR 1400

Hotline: +63 83621138

Email: emailus@siomai.house

Order Online 24/7

STORES

MONDAY – SUNDAY

09:00 AM – 06:00 PM

Bernabest Foodhouse Corporation

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