Shell SFMC Lead Capture Form

First Name: *

Last Name : *

Email Address : *

Phone Number : *

Company Name : *

Job title:*

City : *

State: *

Pin Code : *

GST Number:

Company Registration Number:

Cars *

Vans *

Trucks *

Buses *

Total Volume in litres *

What products are you interested in?

Fuels (Diesel/Petrol)

E-Mobility

Bulk Diesel Delivery

Lubricants

Others

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