Kunde werden

* = Mandatory field

Type of company*

Name of company*

Sector

Title

First name*

Surname*

Street / house number*

Postcode*

Place*

Telephone number*

Mobile number

Fax number

E-mail Address*

Homepage (URL)

Card function*

Authorized to purchase / name 1

Authorized to purchase / name 2

Authorized to purchase / name 3

Authorized to purchase / name 4

Trading licence/qualification certificate

Bitte als JPG oder PDF Datei (max. 2MB)

Yes...I would like you to receive regular information on special offers and news. You can cancel this at any time by e-mail or fax.

YES...by ticking this checkbox, I confirm that I am self-employed and that my future purchases shall primarily take place in the context of my commercial activity.

Other remarks

* = Mandatory field