PROFILE INFORMATION
LICENSEE DETAILS
HOW TO REGISTER AND SUBMIT
Name of Licensee
Licensee Name is required.
Website
Web address is required.
Physical Address
Physical address is required.
Postcode
Postcode is required.
Licensee Categories
Please choose
Network Facility
Network Service
Application Service
Online Content Service
Content Services
Courier Service License
Other
Licensee Certificate No
TCRA license certificate
Upload jpg, jpeg, png, doc, docx or pdf and less than 5MB in size.
PRIMARY CONTACT
Full Name
Your Full Name is required.
Email
Please enter a valid email address.
Telephone Number (Mobile)
Your telephone number is required.
Telephone Number (Alternative)
Your telephone number is required
SECONDARY CONTACT
Full Name
Your First Name is required.
Email
Please enter a valid email address.
Telephone Number (Mobile)
Your telephone number is required.
Telephone Number (Alternative)
Your telephone number is required
REGISTER
