Customer application form
English
Dutch
English
German
Date
:
10/15/2019
Full Business Name
*
:
Street + Number
*
:
Zip Code
*
:
City
*
:
Country/State
*
:
Telephone
*
:
Mobile
*
:
Fax
*
:
Contact Person First Name
*
:
Contact Person Last Name
*
:
Function
*
:
E-mail Address
*
:
Accounts Payable Contact
*
:
E-mail Address
*
:
Website
*
:
VAT Number
*
:
Business License Number
*
:
License Number
*
:
Upload file
Only pdf file is allowed
Without Proof of Business Number we cannot process your application!
Shipping Address
(If different than the above)
Name
:
Street
:
Zip Code
:
City
:
Business Details
Your company is considered
*
:
Dealer
Distributor
Engine Rebuilder
Repair Shop
You sell primary to
*
:
Trade
Consumers
Your sales organisation contains
*
:
Workshop
Showroom
Webshop
Warehouse
Business opening hours
*
:
(eg. 18:17 or 6:17pm)
Number of Employees
*
:
Segment
*
:
Dirt / MX (A)
Streetbikes (B)
ATV (C)
Jet Ski (D)
Scooters / 50cc (F)
Automotive (G)
Marine (H)
Brands you are interested to distribute
*
:
Wiseco
ProX
JE Pistons
K1 Technologies
Innovate
Would you like to keep parts in backorder? (We recommend keeping backorders)
*
:
Yes
No
Would you like to have Race Winning Brands Europe arrange the transport?
*
:
Arranged by RWBE
No thanks, we will arrange the transport ourselves.
Remarks
:
By submitting this application form you indicate that you have read the General Terms and Conditions and Compliance policy and FCPA policy and you agree and accept the General Terms and Conditions of Race Winning Brands Europe BV.
General Terms and Conditions
and
Compliance policy
and
FCPA policy
and you agree and accept the General Terms and Conditions of Race Winning Brands Europe BV.
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:
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