Dealer Application

Complete this form to begin your journey as an Eternal International Dealer

Dealer Application Form

Please complete all sections of this form to apply for dealership

1
Personal Info
2
Review
3
Payment

Personal Information

Please provide your personal details

Review Your Application

Please review all information before submitting

Personal Information
Full Name:
Email:
Phone:
Date of Birth:
ID Number:

Complete Your Registration

Make payment to activate your dealership account

Application Reference
Keep this reference for future communications

M-Pesa Payment

Complete your registration with M-Pesa

KSh 3,900.00
Payment Instructions:
  1. Enter your M-Pesa registered phone number below
  2. Click "Initiate Payment" button
  3. Check your phone for M-Pesa prompt
  4. Enter your M-Pesa PIN to complete payment
  5. Wait for payment confirmation
Enter your M-Pesa registered phone number with country code (254)
Processing your payment request...
Payment successful! Your dealership account is now active.
Payment failed. Please try again or contact support.
Secure Application

Your information is protected with industry-standard encryption. We do not share your personal data with third parties without your consent.

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