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This is an application for registration on the Alarga supplier database of products and services ALL THE INFORMATION GATHERED WILL BE TREATED AS STRICTLY CONFIDENTIAL Please complete your company details below, fields marked with a (*) are mandatory.

1. Company Name (*):

2.Main Activity (*)

3. Contact Person :

4.Address (*) :

5.Telephone Number and Fax

6. Website and Email :

7. References :

8.Number of Employees:

9.Terms of Payment: (*)

10.Remarks: (*)