Reseller Application

Company name *

Trading name

Company type / Legal form * Choose… Eenmanszaak — Sole proprietorship BV — Besloten Vennootschap VOF — Vennootschap onder Firma Maatschap CV — Commanditaire Vennootschap NV — Naamloze Vennootschap Coöperatie Other Dutch legal entity Foreign / EU company

KVK / company registration number *

VAT / BTW number

Company website

Street & number *

Postcode *

City *

Country *

First name *

Last name *

Business email *

Telephone *

Position in company

What products do you sell?

Estimated annual purchases < €5,000 €5,000–€15,000 €15,000–€50,000 €50,000+

Physical shop?NoYes

Webshop?NoYes

Webshop URL

Existing order number

Order billing email