Other Names:
(Do not hit the "return" button)

Email Address for correspondence:
(Do not hit the "return" button)

 Permanent Address(address in your home country):
(Do not hit the "return" button)

 Country and citty of present residence:
(Do not hit the "return" button)

Telephone number(Add country and city code):
(Do not hit the "return" button)

Mobile or Pager number:
(Do not hit the "return" button)

Profession/Job Interest:
(Do not hit the "return" button)

Age

Under 18 years old

Between 19 and 24 years old

Between 25 and 34 years old

Between 35 and 44 years old

More than 45 years old

Gender

Male

Female

Purpose of use

Private

Vendor programme of Afrikontakt

Other use

Code type request

Personalised code

Code-Group(Suitable for vendors and persons that process mails through a third party)

Amount paid or to be paid for code/code-group purchase: (Do not hit the "return" button)

Currency

US Dollars

British Pounds

German Marks

Others

Would you like us to put your name and phone number on our vendor list webpage so that potential customers can reach you?

Yes

No

Give us your comments to help us improve our services

AGREEMENT

All information provided by me in the form above as at the time given are to the best of my knowledge accurate. 
I agree to pay for this service as stipulated in Afrikontakt's payment policy.
I agree to be a good citizen of the internet and to do everything within my capability to promote this concept within my clients.
I agree not to abuse the good faith Afrikontakt has in me and to desist from any activity that will be detrimental to Afrikontakt.
I agree that in cases whereby my activities can seriously jeopardize the activities and good standing of Afrikontakt, Afrikontakt reserves the right to terminate their services to me and refund outstanding monies to me after all expenses incurred in respect of the refund has been deducted. This does not affect the right to any further legal action by Afrikontakt against me. 
I agree that all codes or combination of codes approved by Afrikontakt for the use in my transactions shall be kept secret and confidential.
I hereby order Afrikontakt to deliver all letters, greeting cards etc. that has my code or code-group on it and to carry out all other services stipulated in their email to address services once it carries my code or code-group.
I am aware of Afrikontakt's coding system having read through it on their webpage.
I declare that I have fulfilled all requirements of my host country to engage in such activities. 
I agree to abide by all the stipulated terms of this agreement