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? :