Prosound COD Application Form

Company Name *

Registration Number *

VAT Number *

Trading Name *

Physical Address *

Building etc.

City

Province

Postal Code

Country *

Is your postal address the same as your street address?YesNo

Postal Address

City

Province

Country

Number of Directors / Members123

Director 1 Details

First Name *

Last Name *

Director-1: ID Number *

Director-1 Email Address *

Director 2 Details

First Name

Last Name

Director-2: ID Number

Director-2 Email Address

Director 3 Details

First Name

Last Name

Director-3: ID Number

Director-3 Email Address

Landline

Mobile Number *

Date *Day/Month/Year

Your Sales Person

First Name

Last Name

Declaration & Agreement

By completing this form, I certify that all information provided is true, accurate, and complete. I understand and agree that ticking the box below and typing my name constitutes a legally binding electronic signature, carrying the same weight and enforceability as a handwritten signature.

Acknowledge *I accept the terms and conditions and formalize this agreement.

First Name *

Last Name