EICHERT - Onlineshop

Ich want to become a customer

Please answer the following questions so that we can check your registration wish:

* Required information

Company name:*

Street and No.:*

Postcode:*

City:*

Country:*

VAT-ID:

Managing director and company owner:*

Contact person salutation: *	Mr. Ms.

Contact person first name: *

Contact person last name: *

Telephone:*

Telefax:*

Website:

eMail adress:*

Number of employees in the company:

Activity (multiple selection possible):*	Retail trade with store business Retail trade (several branch offices) Online retail Wholesale

Do you sell at Ebay?*	Yes No If yes: your Ebay member name

Your product portfolio:*

In which products are you primarily interested?*

Other notes:

Newsletter:	Yes, I want fo be informed by eMail

Please send us a valid trade proof parallel to your enquiry by fax to +49 (0)221-4200599 !