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Online Store Registration Form
Account Information
fields marked * must be filled
Username*
Email*
The information below is optional but required for delivery !
First Name
(Required for delivery)
Last Name
(Required for delivery)
GSM No. (e.g. 0XXXXXXXXXX)
State
Abia
Abuja
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
Gombe
Imo
Jigawa
Kaduna
Kano
Katsina
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zamfara
location
Barnawa_Kaduna
Goningora
Kabala_Kaduna
Kakuri_Kaduna
Badarawa_Kaduna
Malali_Kaduna
Kamazo_Kaduna
Narayi_Kaduna
UngwarMeigero_Kaduna
NasfatVillage_Kaduna
SabonTasha_Kaduna
UngwarBoro_Kaduna
NNPC-Indomie_Kaduna
YakowaRoad_Kaduna
UngwarDosa_Kaduna
UngwarRimi_Kaduna
TudunWada_Kaduna
KadunaCentralArea_Kaduna
Jaji_Kaduna
Afaka_Kaduna
ZariaPark_Kaduna
Address
Site Password Information !
Password*
*Password should not be similar to Username
*Password must contain at least 8 Characters
*Password must contain at least a letter or digit
Confirm*
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