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Business Information

Business name:
Business address:
Business city:
Business phone:
Business alternate phone:
Business e-mail:
Business website:
Tax Identification No.:
Client and Worker Information

Name and address of Client or Contractors:
Category of workers you are supplying or intent to supply:
Salary Range (Low to High):
Gambian Employees:
Non-Gambian Employees:
Additional Information

Additional Information:
Attachments:
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Declaration

I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application.