Ajman Accessibility Form

Business / Service Name (Ar) *

Business / Service Name (En) *

Logo *

Multiple Images *

Target Disability Group *

Category *

Account holder Email * You will receive a username & password after launch to update your info

Brief Description (Ar) *

Brief Description (En) *

Email *

Phone *

Facebook URL

Instagram URL

X URL (Twitter)

Website URL

Discount Title (Ar)

Discount Title (En)

Discount Value

Start Date

Expiry Date

Discount Image

Address

City *

Latitude

Longitude

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