Customer Information Data
Captured by
**
Marishka Ferreira
Riaan Goosen
Customer Name
**
Lastname
**
Company
**
Designation/Job Title
Contact Number
**
Mobile number
**
Email
**
Query
**
Catalogue Request
General information
Onsite Store Enquiry
Price Query
Proposal Presentation Request
Request for Company Profile
Vending Machine Enquiry
Other
Other industry
Province
**
Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
North West
Northern Cape
Western Cape
None
Country
**
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cabo Verde
Cameroon
Central African Republic (CAR)
Chad
Comoros
Cote d'Ivoire
Democratic Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Republic of the Congo
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
South Sudan
Sudan
Swaziland
Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Other
Other country
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Current client
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Other
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Notes
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