Orders – Medac

CUSTOMER CODE
DATE
ORDER NR.
Customer/Distributor Name*
VAT number
Address*
Street Address * City * Postal Code *
Telephone*
Email*
Delivery date*
Delivery address*
Closing day
Delivery terms
Payment terms
Bank details
IBAN code
UNLESS APPROVED BY MEDAC
Mandatory fields
UNLESS APPROVED BY MEDAC
Type Print code Design Nr. Rev. Nr. Design description Quantity Price
Print settings/layout
1
2
3
4
Agent
Customer
Verified and approved
*
- I have read and accepted the Sales Terms
*
- I have expressly approved the provisions pursuant to Articles nr. 1341 and nr. 1342 of Italian Civil Code
*
- I have read the Privacy Policy
*
- I consent to the processing of my personal data for promotional purposes
*
- I consent to the processing of my personal data for communication for promotion
*
- I have finished to fill the form and I want to send it
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UNLESS APPROVED BY MEDAC