BOTE CENTRAL, INC.

#21 Graceful cor Menchie Streets

BF Almanza Subd., Las Pinas City, Philippines
Telefax (+632) 8050713 ;(+632) 836 0216
www.arengga.com : basil@arengga.com

PLEASE NOTE: Applicant must have an existing business duly

registered

Applicant Information
Name:
Date of Birth:
Sex:
Phone Number:
Mobile Number:
Citizenship:
Permanent Address:
Shipping Address:
Two (2) Identification Numbers*

ID 1 Type:
ID 1 Number:
ID 2 Type:
ID 2 Number:

Business information
Business Name:
Address:
Business permit
number:

Signature of Applicant over Printed Name / Date

**ID Types presented must be recognized by the Respective Government.

Required documents to be attached

1. Photocopy of the two valid ID's (front and back)
2. International distributor member must attach photocopy of their Business
registration permit.