Seletti S.p.A. Via Codebruni Levante, 32 - 46015 Cicognara di Viadana MN Italy - Tel. +39 0375 88561 - Fax +39 0375 88843 - c.f./p. IVA: 01221790205 - email info@seletti.it www.seletti.it
    REGISTRATION FORM - CUSTOMER'S DETAILS
    INVOICING
    V.A.T./COMPANY REGISTRATION N.:
    Company name:
    Address:
    Phone:
    Contact Person:
    Email Address:
    Website:
    KEY PERSON (Owner / General Manager / General Director):
    Email Address:


    DELIVERY PLACE:
    Address:
    Phone:
    Contact Person:
    SHOP ADDRESS (if different from above address)
    Address:
    Phone:
    Contact Person:
    DELIVERY TERMS:


    FORWARDING AGENT: MMART
    Preffered Express Courier (for samples):
    Express courier international Contract N. :
    Special truck required? (small for city center): Yes | No
    Do you have a forklift at unloading point? Yes | No
    Type of business:
    No. Of Shops:
    No. Of Stores
    Other:
    What type of products do you sell?:
    LIGHTING
    ART DE LA TABLE / TABLETOP
    FURNITURE
    STATIONERY
    OBJECTS AND DECORATION
    OTHER / CONCEPT STORE
    What other brands do you sell?:
    Accounting contact person:
    Phone:
    Mobile:
    Email:
    PAYMENT TERMS: (NEW ACCOUNT REQUIRE ADVANCED PAYMENT)

    I agree to send the above information to Brands Embassy Agency, knowing they will be used in respect to the Privacy laws to register my business as a Seletti customer: