Reseller Registration Form

Platform: Atlantic Attire E-Commerce

Form Type: New Reseller Application

Date: 29 Jul, 2026

Authorized Reseller

1 Personal Information

Full Name *

Shop Name

Email Address *

Mobile Number *

🇧🇩 +880

Full Address *

2 Identity Verification

National ID (NID) Number *

NID Card Front Side Photo *

🪪

Upload NID card front side image

JPG / PNG — Max 10MB

Profile Photo / Shop Logo *

📸

Upload your photo or shop logo

Clear and colorful image — JPG / PNG

3 Payout / Withdrawal Method

Payment Method *

Payment Number / Details *

4 Account Security

Password *

Confirm Password *

📋 Terms & Conditions

I have read, understood, and fully agree to the Terms & Conditions above. I certify that all information provided is accurate and true.