Details about Registrant

Fieldset

Name of the Company
NUIS
Date Format: day/month/year
City
Adress
Telephone
Fax
Email
Website
Shareholders
Legal representative
Contacts Company Contacts
Contact Person for notifications purpose, if different from Company Contacts
Related companies, subsidiaries, quota participation, representatives, if any (please insert legal name/s)

Section 2. Company Profile / information on business activity

Description of business activity:
Activity territorial coverage:
List of authorized products:
Number of employees:
Turn-over (last financial year):
Certifications:
Other countries related to the business activity:
Membership in other Organizations e.g. professional, international, etc.:
Price and Awards:
Others, if any:
Details about Registant
For the Company : Authorized Representative: Name/Surname:

Verification

Please enter any two digits *Example: 12
This box is for spam protection - please leave it blank