St Lucia
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Employer Registration

Application Form
Please fill in the form to register as an Employer.
* indicates a required field
* Business Registration No:  
* Business Name:  
* Business Sectors
* Business Address 1:  
  Business Address 2:
* Business City/Town:  
* Business Country
  Business Zip:
* First Name:  
  Middle Name:
  Last Name:
* Phone Number: 10 Digits eg. 7589271234    
  Fax Number: 10 Digits eg. 7589271234
* Email Address: e.g.    
Enter the code as seen above in the Security text box provided