POLE AVENIA

1- Company information

Company name

Website

Logo (Format .jpg or .png)

NAF code

Legal status

Company registration number

Intracommunity VAT number (if concerned)

Workforce

Company type

Markets several possible options

Category one possible choice

Activities

My company is in France ?

Address(Number and street)

Additional address information

Postal Box

Zip code

City

Region

Country

Company name
Mentionnez le nom que vous souhaitez voir figurer sur l’entête de votre facture

Full billing address
Mentionnez l'adresse que vous souhaitez voir figurer sur l'entête de votre facture

2- Company representative

Director (first name)

Director (last name)

Director (function)

3- Referent and representative at the Avenia GA

First name

Last name

Position

Phone

4- Information and payment

J'ai un accord de partenariat

Billing point of contact

First name

Last name

Phone

Payment method

Would you like to include an order number on your invoice *
for accounting purposes? NonOui

5- EartH₂ program

Participate to eartH₂ program

Your subscription to POLE AVENIA