	De Beers Canada Inc. - Victor Project Online Vendor Registration A Division of De Beers Canada Inc. 2020 Winston Park Drive, Suite 303, Oakville On L6H 6X7

Online Vendor Registration - Company Information

Complete all applicable sections. Items marked with '*' are required.

Company Name*
Corporate Address
Address 1*		Address 2
City*		Province*
Country*		Postal Code*
Phone*		Fax
Delivery Address
Check if Same as Corporate Address If not, please complete following section
Address 1*		Address 2
City*		Province*
Country		Postal Code*
Phone		Fax
Website
Address Servicing Project
Contact*		Title
Phone*		Fax
email		Website
Check if Same as Corporate Address if not, please complete following section
Address 1*		Address 2
City*		Province*
Country		Postal Code*
Other Locations in the Province