Company Name

Street and house number

Postal Code

City

State

Country

Contact person:
First Name and Last Name

Email Address

Phone number

Contact person for invoicing (if different from the above data):
First Name and Last Name

Email Address

Phone number

Technical contact person (if different from the above data):
First Name and Last Name

Email Address

Phone number


VAT number

Chamber of Commerce (KvK) number

Microsoft MPN ID


Desired login name

Password