Company Registration Form
* Required
GENERAL
Company name:
*
Your answer
Website:
*
Your answer
Interested in
*
Drop ship
Stocking
Other:
Required
Employees:
*
Choose
1-2 employees
3-10 employees
11 - 50 employees
> 50 empoyees
Turnover:
*
Choose
< 100 000 EUR
101 000 - 200 000 EUR
201 000 - 500 000 EUR
500 000 EUR - 1 000 000 EUR
> 1 000 000 EUR
Founded:
*
Your answer
BILLING ADDRESS
VAT Number:
*
Your answer
Street Address:
*
Your answer
Postal code / ZIP:
*
Your answer
City:
*
Your answer
Country:
*
Your answer
Primary contact person:
*
Your answer
Invoicing email:
*
Invoices will be sent to this email.
Your answer
SHIPPING ADRESS
Company name:
Live blank if same as in billing address
Your answer
Street Address:
Live blank if same as in billing address
Your answer
Postal code / ZIP:
Live blank if same as in billing address
Your answer
City:
Live blank if same as in billing address
Your answer
Country:
Live blank if same as in billing address
Your answer
Primary contact person:
*
Your answer
Phone number:
*
Your answer
Email:
*
Your answer
Submit
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