ORDER FORM

INFORMATION ABOUT THE COMPANY

Name of the company (*):

National Trade Register no. (*):

Bank account (*):

Bank (*):

C.U.I. (Unique Identification Code) (*):

Address (*):

Phone/Fax (*):

Email:

Note: For a proper registration of the information, you are required to fill in all the spaces marked with *.


REPREZENTATIVE FOR THE COMPANY
(the person who will sign the contract)

First name and last name (*):

Position in company (*):

Phone (*):

Email:

Note: For a proper registration of the information, you are required to fill in all the spaces marked with *.


Please write your order underneath:


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