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General information

Fields marked with ( * ) are required !
Company name (*)
Fill in the companyname as it is registered with the Chamber of Commerce
Mailing Address (*)
Fill in the mailing address from your company
Postal code and City (*)
Fill in the postal code and city from your company
Country (*)
Fill in the country from your company
Contact person (*)
Fill in the contactperson from your company
Is the mailing address equal to the physical address from the nursery? (*)
Please make a choice
Physical address (*)
Fill in the physical address from your company
Postal code and City (*)
Fill in the postal code and City of the physical address
E-mail address (*)
Fill in the E mail address from you company
Website name from the company
Fill in the domain name from your company (if there is one). example: www.mycompany.com
Do you have a separate e-mail address for your invoices? (*)
Make a choice
E-mail address invoices (*)
Fill in the E mail address for invoices from your company
Telephone (*)
Fill in your phone number
Mobile Telephone
Fill in your mobile phone number
Chamber of Commerce no (*)
Fill in your Chamber of Commerce no
Extract Chamber of Commerce (*)
Please add a file
Please, add a copy of an Extract of the Chamber of Commerce (PDF or jpg file)
VAT-number (*)
Fill in your VAT number
   

Cultivation and location data

Fields marked with ( * ) are required !
Please fill in your main cultivation? (*)
Make a choice
Other cultivation (*)
Fill in your cultivation
Indoor- or outdoor crops location 1 (*)
Make a choice
Total surface area indoor crops (*)
Please fill in the total surface area indoor crops
Total surface area outdoor crops (*)
Please fill in the total surface area outdoor crops
Number of locations (*)
Please fill in the number of locations

Location 2

Address of nursey 2 (*)
Please fill in the address of nursey 2
Postal code and city 2 (*)
Please fill in the postal code and city 2
Indoor- or outdoor crops (*)
Make a choice

Location 3

Address of nursey 3 (*)
Please fill in your address of nursey 3
Postal code and city 3 (*)
Please fill in the postal code and city 3
Indoor- or outdoor crops (*)
Make a choice

Location 4

Address of nursey 4 (*)
Please fill in the address of nursey 4
Postal code and city 4 (*)
Please fill in the postal code and city 4
Indoor- or outdoor crops (*)
Make a choice

Location 5

Address of nursey 5 (*)
Please fill in the address of nursey 5
Postal code and city 5 (*)
Please fill in the postal code and city 5
Indoor- or outdoor crops (*)
Make a choice

Location 6

Address of nursey 6 (*)
Please fill in the address of nursey 6
Postal code and city 6 (*)
Please fill in the postal code and city 6
Indoor- or outdoor crops (*)
Make a choice

Location 7

Address of nursey 7 (*)
Please fill in the address of nursey 7
Postal code and city 7 (*)
Please fill in the postal code and city 7
Indoor- or outdoor crops (*)
Make a choice

Location 8

Address of nursey 8 (*)
Please fill in the address of nursey 8
Postal code and city 8 (*)
Please fill in the postal code and city 8
Indoor- or outdoor crops (*)
Make a choice

Location 9

Address of nursey 9 (*)
Please fill in the address of nursey 9
Postal code and city 9 (*)
Please fill in the postal code and city 9
Indoor- or outdoor crops (*)
Make a choice

Location 10

Address of nursey 10 (*)
Please fill in the address of nursey 10
Postal code and city 10 (*)
Please fill in the postal code and city 10
Indoor- or outdoor crops (*)
Make a choice
   

Memberships

Fields marked with ( * ) are required !
Are you a member of an auction? (*)
Make a choice
First membership: name of auction (*)
Please fill in the name of the auction
First membership: your auction number (*)
Please fill in the number of the auction membership
Second membership: name of auction (*)
Please fill in the name of the auction
Second membership: your auction number (*)
Please fill in the number of the auction membership
Third membership: name of auction (*)
Please fill in the name of the auction
Third membership: your auction number (*)
Please fill in the number of the auction membership
Fourth membership: name of auction (*)
Please fill in the name of the auction
Fourth membership: your auction number (*)
Please fill in the number of the auction membership
Fifth membership: name of auction (*)
Please fill in the name of the auction
Fifth membership: your auction number (*)
Please fill in the number of the auction membership
Are you a member of another institution? (*)
Make a choice
Membership : name of institution (*)
Please fill in the name of the institution
Number of membership (*)
Please fill in the number of the membership
Second membership: name of institution (*)
Please fill in the name of the institution
Number of membership 2 (*)
Please fill in the number of membership
Third membership: name of institution (*)
Please fill in the name of the institution
Number of membership 3 (*)
Please fill in the number of membership
   

Other data

Fields marked with ( * ) are required !
Have you participated in MPS-ABC before? (*)
Make a choice
What was your MPS number (*)
Fill in your MPS number
Starting date registration (*)
Please make a choice
Registration via (*)
Make a choice
*MY-MPS Basic registration is a 4- weekly registration program and is included in the MPS-ABC participation fee. For MY-MPS daily registration MPS calculates an extra fee. Please contact your local coordinator for a quotation.
Reason for application (*)
Please fill in your reason of application
We would like to know the reason for your application for MPS-ABC. This could be: taking responsibility, additional value, market demand, etc.. And if the reason is market demand could you please mention which party is demanding MPS?
   

Payment data

Fields marked with ( * ) are required !
We would like to pay via (*)

Make a choice
S€PA business-to-business direct debit mandate
Name of creditor : ECAS B.V.
Address of creditor : PO Box 533 | 2675 ZT Honselersdijk | the Netherlands*
Incassant ID : NL40ZZZ280738980000
Direct debit reference : this will be your standard debtor number (MPS/client no.)
Name company (*)
Fill in the companyname as it is registered with the Chamber of Commerce
Address company (*)
Fill in the physical address from your company
Postal code and City company (*)
Fill in the postal code and City of the physical address
Country (*)
Fill in the Country of the physical address
Account no. (IBAN) (*)
Fill in the Bank account (IBAN)
Bank Identification (BIC) (*)
Fill in the BIC
Agreement SEPA (*)
Please accept the agreement
By signing this form you authorise:
1. MPS-ECAS to send direct debit instructions to your bank for the annual
MPS-ABC participation fees and/or the certification charges and
2. your bank to debit an amount from your account in accordance with
the instructions of MPS-ECAS.
This mandate is intended solely for payments between companies.
Collection invoices will not be collected sooner than 14 days
after the invoice date and the collection amount will be the same as the invoice amount.
The invoice should be regarded as notice of the collection order.
(You always have 56 days to have the amount of the collection refunded).
Agreement MPS conditions (*)
Agree the general conditions of MPS
Full name and surname of the applicant (*)
Fill in the surname and name
Agreement date (*)
Ongeldige invoer
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