Please let us know a contact person, whom we can contact if there are any questions.

Form of Adress:

Fore name:

Last name: *

E-Mail: *

Phone:

For the preparation of a quotation, we require further information about your company, as the respective terms and conditions partly depend on its location.
Please enter the desired delivery address here!

Company name *:

Division:

Street *:

Postcode & City *:

Country: *

Homepage:

Please tell us a few details so that we can support you optimally.

Socket:

Quantity: *

Please provide us with the desired number of pieces for the offer.
If you wish to make an offer for several pieces for costing purposes, please separate them with commas.

Projekt Name: *

When requesting larger numbers we ask for a project name.
We often get a »Special Quote« from the manufacturer, which is only valid for the specified project.
Of course all information will be kept strictly confidential.

End customer:

When requesting a larger number of pieces, we ask for information of the end customer, unless you have your own production. Again, we will use this information to receive a »Special Quote« with attractive special conditions.

Of course all information will be kept strictly confidential.

Application:

Captcha *: