Supplier subscription form





Legal form of the company*



Number :

Post Box :

Post Code* :

City* :

Country* :

Tel* :

Fax :

Email* :

Website :

VAT* :

Intra-Community VAT (if outside Belgium) :

Company registration number :

Type of activity* :
ManufacturerWholesalerService provider

Describe the activity (in a few words) :

For which service/sector do you wish to be a supplier ?
Great HeightsMontageIndustry (sites)Industry (workshop)Industry (both)Monnaie FranceAdministration

Ordering address (if different from headquarters) :

Invoicing address (if different from headquarters) :

Affiliation to a corporate group :

Subsidiary (subsidiaries) :

Number of employees* :

Bank details



Payment conditions* :

60 days by the end of the monthOther

Other (explain please) :

Contact persons

Management* :

Sales* :

Production* :

Shipping* :

Reception of the goods* :


Schedule for receiving/ collecting the goods* :

Is there a minimum quantity to order* ? Yes-No, if yes what is it ?

Which is the time limit for a 24-hour delivery* ? If there is one, what is this limit ?

Do you deliver exceptional orders on weekends and bank holidays* ? Yes-No, if so, on what terms ?


Is there a possibility to exchange the products* ? Yes-No, if so under what conditions ?

After-sales service

Contact person* :


Do you have any international quality standards qualifications?

DIN EN ISO 9001DIN EN ISO 14001Other qualifications?

Other (explain please) :

Who is in charge of Quality ?

Does your company follow a quality, safety and environment policy? Describe.

Do you regularly control your products?

Other useful pieces of information :

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