Accelonix new customer form

Please fill in below form as complete as possible, fields marked with (*) are required.

A confirmation will be send to your e-mail to validate a successful form subscription,
In case you did not receive confirmation e-mail please refill the form again or contact Accelonix directly.

Problems with sending the BELOW form?

Please download form as excel file, fill in completely and email to logistics@accelonix.nl.

Download : Accelonix new customer form (2024).xlsx

DELIVERY ADDRESS:

Company name (*)

Department (*)

Contact name (*)

Street (*)

Zip Code (*)

City (*)

Country

Phone number (*)

Email address for order confirmation (*)

Website

INVOICE ADDRESS:

Invoice Company name (*)

Invoice Department (*)

Invoice Contact name (*)

Invoice Street (*)

Invoice Zip Code (*)

Invoice City (*)

Invoice Country

Invoice Other (*)

Phone number Accounting department (*)

Email address for digital invoice(*)

VAT number(*)

CoC number(*)

BANK DETAILS:

Name of Bank

IBAN no(*)

BIC/Swift code

Remarks

35850

Problems with sending the form?

Please download form as excel file, fill in completely and email to logistics@accelonix.nl.

Download : Accelonix new customer form (2024).xlsx

Accelonix new customer form

Problems with sending the BELOW form?

Problems with sending the form?

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