FINTECH BELGIUM PARTNERSHIP / MEMBERSHIP APPLICATION
Sign in to Google to save your progress. Learn more
YOUR BUSINESS
Company Name *
Legal Form *
sprl, vzw, Ltd., SA, GmbH, ...
VAT Number *
Address *
Address 2
Building Number *
Zip Code *
City *
Country *
INVOICE Address *
INVOICE Address 2
INVOICE Building Number *
INVOICE Zip Code *
INVOICE City *
INVOICE Country *
Invoice VAT Number *
Website *
Linkedin *
General email *
Description of your products/services *
3-5 tags to define your business *
separate with comas. this will enable us to categorise your business on our website and other communications, and help our community to understand more easily what you do
Launch year *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report