Registration

Company name*

Billing address*

Zipcode*

City*

Country*

Phone number*

Company website

Type of business*

VAT number*

EORI number*

Last name*

First name*

Function*

Phone number*

Email*

* For sending invoices

Delivery address (only if different from billing address)

Unloading dock

Yes No

Notes (opening days, opening hours,...)

Bank details (in case of refund)

How did you know us*

* Required fields

I agree to my personal data being collected by Vert Espace for the above request

Account opening form