Registration Form


PLEASE NOTE : All the fields marked * are mendatory.

User Registeration Form for smgl.net
General Information
Title
First Name *   
Last Name *   


Address *
City *
State
Country *
Post Code *
Landline No    
Mobile No    
(Please fill atleast one Contact No)
Login Information
E-mail *
Your Email will be treated as userid to login at smgl.net
Password *
Retype Password *
Shipping Information              Same as Above Different
Answer some interesting questions and GO AHEAD !!
From where do you know about our site ?
What is your first time estimated purchasing ?
If you like our product's quality, would you like to be our regular custommer ?
Yes
No

For what purpose you are purchasing ?
Personal Use
Business Use
If for business use, then : Type of business :
Wholesaler
Retailer
E-bay Seller
Do you have business licence ?
Yes
No

Would you like to get jewelry newsletters from us ?
Yes
No
What type of newsletters do you want ?
Jewelry promotion newsletters
Jewelry informative newsletters

Choose your payment mode :
Credit Card
Bank Transfer
Western Money

Any special comments :
Insert Given text into box (Case Sensitive)