Agent Application

fill in the details below to apply to be an IceVolt agent.

First Name

Last Name

Email Address

Phone Number

Address

Recent photograph

Picture of NIN slip

Virtual NIN

Do you own a registered business?

Yes

No

Do you have any criminal records?

Yes

No

States of business operations(seperate with commas)

How did you hear about us?

Tell us about your business/customer acquisition plan

Clean Reliable Energy

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