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 Mr|    Mrs *

First and last name *


Email *


Please re-enter your e-mail *


Phone Number *

Billing address

Company or first name *


Street address *


Zip code *


City *


Country *


VAT Number *

Indicate "no" if you don't have any VAT number

On-site removal in our offices in Brussels
Delivery by UPS (+ add the UPS forwarding costs)

Delivery address (only if different from the address for the invoice)

Corporate name or first name


Street address


Zip code


City


Country 

Do you want to pay via credit card / Paypal ?

Yes
No

 
If you want to pay with credit card, we will send you an email explaining how to pay via the very safe Paypal website.

Model(s) that you purchase

Model *

Number of pieces*


Model

Number of pieces


Model

Number of pieces

If you have any comments

The data and information will not be forwarded to any other body or organization.