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1. What is your name / नाम / नाव / பெயர்? *

2. What is your email address / ईमेल / மின்னஞ்சல்? *

3. What is your mobile number / मोबाइल नंबर / கைபேசி எண்? *

4. Please select the category(s) that best describe your products. *

5. Do you have photographs or a descriptive video of your products?
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6. Have you registered on our B2C WomenMark platform? *
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7. Payment Mode / भुगतान का प्रकार / देय मोड / கட்டண முறை *

8. Payment Confirmation / भुगतान की पुष्टि / கட்டண உறுதிப்படுத்தல் (PayTM Receipt Number / NEFT Number / RTGS Confirmation Number)