Supplier Registration Form

Company name (*)
(state legal name)

ABN / VAT number (*)

Postal Address

P.O. Box

Postal or Zip code

Visit Address

Building and floor

Street name (*)

Postal or Zip code (*)

City (*)

State

Country (*)

General Contact Details

Telephone (*)
(Or main switchboard number, including country code)

After office / emergency number

Fax

E-mail (*)

Internet homepage

Please specify you standard payment terms

Short description of provided products and/or services and market coverage (*)

Please specify if this company is part of an association

Contact Person

Function (*)

Department

First name (*)

Last name (*)

Title

E-mail (*)

Direct telephone (*)

Mobile number (*)

Direct fax

I herewith allow Nostromo Group Australia Pty Ltd to share the information given, with other ship owners/managers with whom they have common purchase contracts or from buyer network. (*)

Yes
No
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Postal Address

Visit Address

General Contact Details

Contact Person

Contact us

Vecom Marine B.V. Distributor

Solarglide
representative

Would you like to become our appointed Chain