Creation of customer account

Your personal data (* necessary information )

Salutation:*

First name:*

Last name:*

Date of birth:*e.g. 21/05/1970

E-mail address:*

Confirm e-mail:*

Company data

Company name:

VAT Reg No:for EU-Countries only

I would like to receive interesting offers by e-mail. My e-mail address will not be shared with other companies. This consent to use my e-mail address for advertising purposes can be revoked at any time with effect for the future.

Your address

Street/No.:*

Addition to address:

Postcode:*

City:*

Country:*

Your contact information

Telephone number:*

Telefax number:

Secure your information with a password.

A secure password should be at least 5 characters in length and should include uppercase and lowercase letters and numbers and special characters (except Backslash "\").

Your password:*

Confirm password:*

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Information

Payment methods

Die Box kann unter tpl_modified_responsive/boxes/box_miscellaneous.html verändert werden. Die Sprachvariablen befinden sich in der Datei tpl_modified_responsive/lang/german/lang_german.custom.

Newsletter subscription

E-mail address:

The newsletter can be canceled here or in your Account at any time.