New Customer Card
Sales Channel
*
Please Select
E-shop
Pickup shop
Sales Responsible
Telesales
Sales Consultant Sales Unit
*
Sales Unit
Sales Consultant Email
*
example@wurth.ae
Customer Name
*
Kindly provide the details as per the Trade License
Telephone
*
*97140000000
Fax
*9710000000
Mobile
*
97150000000
Customer Company Email
*
example@example.com
Office Address
*
Street Address
Street Address Line 2
City
State / Province
Po Box
Pinned Location
*
*Link from Maps is required
Emirates/City
*
Customer Business Code
*
No. of Employees
*
Trade License
*
Browse Files
File Format( pdf, jpg, jpeg, png, gif)
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of
VAT Certificate
Browse Files
File Format( pdf, jpg, jpeg, png, gif)
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of
LPO
Browse Files
File Format( pdf, jpg, jpeg, png, gif)
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of
Note
Contact Person
Purchaser
*
Accountant
Store Keeper
Submit
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