ECS Request Form

Responsible Sales Rep*

Additional Sales Rep(s)

Customer Title*

First Name*

Last Name*

E-mail*

example@example.com

Company Name*

Job Title*

Country*

Phone Number

Take a picture of business card / QR code

Additional Customers attending the meeting (if applicable)

Who is the prospect?

ClientSupplier

Products / services of interest

Supporting Documents

Specify Document(s)

Please specify with detail.

Preferred Follow Up(s)

Meeting / VisitCall / TeamsWebinar

Preferred Date of Follow Up

Hour MinutesAM/PM Option

Sample Request(s)

YesNo

Specify Sample Product(s)

Enter full address including country and postal code.

Sample Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Notes / Inquiries

Data Protection Information

OQEMA Group, represented by OQEMA AG (Schlossstr. 39, D-41352 Korschenbroich; E-mail: info@oqema.com – hereinafter referred to as "OQEMA") is responsible for the processing of your personal data under data protection law. You can reach the company data protection officer at dataprotection.de@oqema.com. Information on the members of the Oqema Group can be found under OQEMA Contact. To make contact for sales purposes as well as to initiate and carry out business relationships, OQEMA collects and processes contact details as well as any other information provided by end customers and business partners. Your data will not be disclosed to third parties unless it is necessary for the execution of the business relationship (e.g. sample shipping, order processing, etc.). The legal basis for processing and, if applicable, transmitting data to third parties is Article 6(1)(b) of the GDPR. OQEMA uses service providers that are integrated into the processing in a manner that is compliant with data protection requirements. Adequate data protection levels for integrated non-European service providers are ensured by EU Commission adequacy decisions or the conclusion of current EU standard data protection clauses. Further information on data protection and your rights as a data subject can be found here.

Customer Data Consent

I consent to the use of my provided contact details by the members of the OQEMA Group to contact me for marketing and promotional purposes via telephone, email, SMS or other digital channels. The consent is valid from the date of signature. Unless I revoke my consent, it is valid for an unlimited period of time.

Customer Media Consent

I consent to OQEMA taking and storing photographs of me during my visit to the OQEMA trade fair stand for internal group documentation and archiving purposes and for using and publishing these photographs with and without my name being mentioned for OQEMA's own advertising purposes in print and online media, as well as in marketing campaigns. Additionally, I consent to these photographs being published on the social media platforms LinkedIn, Instagram, Facebook and Twitter for public relations purposes as part of OQEMA's online company presentations. I am aware that LinkedIn, Instagram, Facebook and Twitter are US companies that are subject to US laws and in particular to extensive access rights of US surveillance authorities, and that there is a risk that my data may be processed by US authorities for control and monitoring purposes without me having appropriate legal remedies. I am aware that my photographs are accessible worldwide after publication in print and/or online media and that third-party reuse of these images cannot be generally excluded. The consent is valid from the date of signature. Unless I revoke my consent, it is valid indefinitely.

Revocation

I may revoke the consent(s) granted here in whole or in part at any time with effect for the future. Revocation of consent shall not affect the lawfulness of processing based on consent before its revocation.

Date

Signature*

ECS Request Form

Field of Interest

Documents

Follow up

Sign and Send