Creation of customer account

Your personal data (* necessary information )

Salutation:
Mr. Ms./Mrs.*

First name:
 *
Last name:
 *
E-mail address:
 *
Confirm e-mail:
 *

Company data

Company name:
 
VAT Reg No:
 * for EU-Countries only

Your address

Street/No.:
 *
Postcode:
 *
City:
 *
Country:
 *

Your contact information

Telephone number:
 
Telefax number:
 

Secure your information with a password.

Your password:
 *
Confirm password:
 *


I have read and agree to the data privacy statement.


* necessary information

I am already a customer

E-mail address:
 
Password:

Anschrift:
Post-Anschrift:
Postfach 10 04 61
D-42804 Remscheid

Besucher-Anschrift:
Güldenwerther Bahnhofstraße 25-29
D-42857 Remscheid
Telefon +49 (0) 21 91 / 7 92-0
Telefax +49 (0) 21 91 / 7 92-375

E-Mail: info@hazet.de
Web: web.hazet.de