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Customer Registration

Application Form

Customer Name*
(Company name as registered in the commercial register)

Short Name *

Short Name : Company Abbreviation

VAT ID

VAT ID: VAT Identification Number

Title* Mr. Mrs. or Ms. Please Select

Academic Title

First Name*

Last Name*

Street, No.*

Post Code/Location*

Phone*

Fax

Mobile Phone

Country* Austria European Union Germany Luxembourg Other Country Switzerland

E-Mail*

Username*

Message

Security Code*