Become a retailer

Please fill in the fields below to become a retailer

Company name *

VAT number *

Street Name + Number *

Zip Code *

City *

Country *

Contact Person *

Email *

Phone Number *

Website *

If your delivery information is the same as above, please check this box and scroll down and continue.

Company name

VAT number

Street Name + Number

Zip Code

City

Country

Contact Person

Phone Number

Website

Invoice email 1 *

Invoice email 2 *

Order Confirmation email 1 *

Order Confirmation email 2 *

Newsletter email 1 *

Newsletter email 2 *

Buyer name *

Buyer email *

Logistic name *

Logistic email *

Accounting name *

Accounting email *

Sales code

Debtor/account group

Debtor/discount group

* This field is mandatory.