Reseller Order Form

Date

Reseller contact name

Reseller

Customer/Organization *

Customer/Organization Adress

Contact at customer *

E-Mail *

ActiveFloor typeKGPrimarySecondarySeniorOther

Floor template

Hardware Model *ONEPRO2FLATMAX2MOBILEMAXSPORTsWallSpecial

Vinyl size *StandardLarge

Licens Payment flow *12 months36 months

Requested delivery date (Shipping date) *

Shipping terms: *Standard EU truck 2-5 days (€250)EU Express air (€ 500)

Special instructions