Register as a new customer

Use this form to register as a new customer. When you have completed the form we can create a customer number for you. You can then place your first order with us.

Registration form

You can register as a new customer using the form below.

Step 1 of 5

20%

Company details
Company name:*
VAT number:*
IBAN number:

Mailing address
Adress*
Street + number City Postal code Country
Phone number:*
E-mail adress:*
Website

Delivery address (if different)
Delivery address:
Street + number City Postal code Country
Delivery times:
Phone number:

Personal information purchaser
Name purchaser:
E-mail adress:*
Phone:
Cell phone:

Your contact
Indicate your preference for your contact person*
- Marianne Kramer (English, German, Dutch, French )
- Klaas Visscher (English, German, Dutch)
- Raja Ranesh (Tamil, English, Dutch)
- Shubham Deshpande (Hindi, English)
- Thu Han (Vietnamese, Thai, Lao, English, German)
- Olivas Policarpo (Spanish, French, Portuguese, English)
Name
This field is for validation purposes and should be left unchanged.