Wholesale Registration WholesaleFirst Name Last Name Company Address 1 Address 2 District - Select -Chamkar MonChbar AmpovChrouy ChangvarDangkaoDoun PenhMean CheyPrampir MeakakraPreaek PnovPur SencheyRussey KeoSaensokhTuol KoukSub District - Select -Boeng Keng Kong 1Boeng Keng Kong 2Boeng Keng Kong 3Boeng TrabaekOlympicPhsar Daeum ThkovTonle BasakTumnob TuekTuol Svay Prey 1Tuol Svay Prey 2Tuol Tumpung 1Tuol Tumpung 2Sub District - Select -Chbar Ampov 1Chbar Ampov 1Kbal KaohNirouthPreaek AengPreaek PraPreaek ThmeiVeal SbovSub District - Select -Bak KhaengChrouy ChangvarKaoh DachPreaek LiebPreaek Ta SekSub District - Select -Cheung AekDangkaoKong NoyKrang PongroPong TuekPrateah LangPreaek KampuesPrey SaPrey VeaengRoluosSak SampovSpean ThmaTiemSub District - Select -Boeng RangChakto MukhChey ChumneahPhsar ChasPhsar Kandal 1Phsar Kandal 2Phsar Thei 1Phsar Thei 2Phsar Thei 3Srah ChakVoat PhnumSub District - Select -Boeng Tumpun 1Boeng Tumpun 2Chak Angrae KraomChak Angrae LeuStueng Mean Chey 1Stueng Mean Chey 2Stueng Mean Chey 3Sub District - Select -Boeng ProluetMittapheapMonourromOu Ruessei 1Ou Ruessei 2Ou Ruessei 3Ou Ruessei 4Veal VongSub District - Select -Kouk RokaPonhea PonPonsangPreaek PnovSamraong KraomSub District - Select -Boeng ThumChaom Chau 1Chaom Chau 2Chaom Chau 3Kakab 1Kakab 2KamboulKantaokOvlaokPhleung Chheh RotehSamraong KraomSnaorTrapeang KrasangSub District - Select -Chrang Chamreh 1Chrang Chamreh 2Kilomaetr Lekh PrammouyRuessei KaevSvay PakTuol Sangkae 1Tuol Sangkae 2Sub District - Select -KhmuonhKouk KhleangKrang ThnongOu Baek K'amPhnom Penh ThmeiTuek ThlaSub District - Select -Boeng Kak 1Boeng Kak 2Boeng SalangPhsar Daeum KorPhsar Depou 1Phsar Depou 2Phsar Depou 3Tuek L'ak 1Tuek L'ak 2Tuek L'ak 3Email Phone Number Please provide any information you feel is relevant in support of your application: Submit Form
