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B2B Business Account request for business web shop Leane Creatief.

Please fill up this form and mail it to Leane Creatief.

After receiving your Business Account request, we willprocess your application.

We will react a.s.a.p.

When youqualify for our purchase conditions, you receive by mail:

your user name - password and conditions

After this you can order at the business web shop www.leanecreatief.com

Company name: *

VAT number: NOTE: Enter VAT number with country code (e.g. GB 111 111 11)

Website:

Chamber of Commerce number:

Gender:

Male Female

First name: *

Last name: *

Email: *

Confirm email: *

Phone:

Street address + No.: *

Zip / postal code: *

City: *

Country: *

Password: *

Confirm password: *

Description of your business activities:

Remarks:

I accept privacy policy (read)