marked areas are required to fill *

Company Name *:  
Company Address *:  
Country *:  
Phone number *:  
Total assets in Euros :  
Total Liabilities in Euros :  
Net Worth in Euros :  
Contact first name *:  
Contact last name *:  
Contact address
(If different than company address) :
Email address *:  
What market(s)/state(s) are you interested in operating in? :  
How many locations? :  
What is the local population of the location(s)? :  
How many employees are located at your facility? :  
Is there anything else you’d like us to know about your business? :  
What is your web site address? :