Application for Getting your Business Online

Name*

First Last

Country Code*

Mobile*

Email*

Business Address*

ZIP / Postal Code City State / Province / Region

Business Name

Business Sector*

What is the nature of your business?*

Manufacturing
Trading
Services

I will be able to provide a Gmail account for Google My Business*

Yes
No

I have access to desktop or laptop.*

Yes
No

I am able to attend a meeting on Google meet or Zoom.*

Yes
No

What was your annual revenue before the Covid- 19?( as in the year April 2019 to March 2020)*

Less than Rs .5.00 Lakh
More than Rs.5.00 lakh but less than Rs 50.00 lakh
More than Rs.50.00 lakh

You were/are selling goods or providing services*

Directly to End consumers (B To C)
To other business (B TO B)

Before Covid- 19 You were running a business from physical location?*

Office /Shop/Home
Virtual/Online

Facilitator Email

External Handholder Email

EHH Engaged Consent

Stay Engaged with EHH only

Consent*

I agree to the terms and conditions and authorise deAsra and deAsra's Partners to contact me on the number provided. This will override the registry with DNC/ NDNC.*

ProspectID

LS Response

Business Rule

Error Code

Response Message

UTM Source

UTM Medium

UTM Campaign

Application for Getting your Business Online

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