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Contact data filling in

Please select whether you purchase as a person or as a company and fill in the required data. The data marked with an asterisk (*) are compulsory.


Customer:
Company name:First name: *
Contact person:Surname: *
Address: *
Town, zip code: *
Country:
Phone *:
Fax:
E-mail: *
Id. No.: *
VAT No.: *
VAT payer:
Billing address is identical with delivery address:

With respect to the fact that sending information by electronic means is governed by Act No. 480/2004 Coll. on Services of Information Companies and according to Section 7 of this Act, business notifications can be communicated through electronic means only if the recipient has granted demonstrable consent for such use of his/her electronic contact, so allow us to ask you for confirmation that you continue to be interested in receiving information from DISKUS spol. s r.o. via e-mail. By ticking this field, you agree with us sending you information.

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