Username*
Email*
First Name
Last Name
Store Name*
https://bacala.in/store/[your_store]
Address 1*
Address 2
Country*
City/Town
State/County
Postcode/Zip*
Store Phone*
FSSAI License/Other approved License*
Shop ACT*
Identity Card (Government Approved)*
GST Declaration*
Password*
Confirm Password*
