VIP DISTRIBUTOR DISCOUNT APPLICATION
- We herewith apply for our VIP DISTRIBUTOR DISCOUNT, as we like to consider to order your products regularly.
- Below please find our company information and our best estimate on our annual volume.
- We understand that AXCENT will review the VIP Discount provided, after a period of 6 months, to match our actual buying volume.
- We fax this form to: + 31 263 893 244
- We are looking forward to receive our VIP Trade Discount % ASAP.
Contact Person:
Title, Position:
Company Name:
Company Address:
Postcode:
Town, City:
Telephone no.:
Fax no.:
Email address:
VAT number:
Estimated annual buying volume: (Please, circle the amount applicable to your company)
€ 1,200.00 + € 2,500.00 +
€ 5,000.00 + € 7,500.00 +
€ 10,000.00 +
Signature:
Date:(DD/MM/YYYY):
