PICK UP FORM

CUSTOMER DATA

* Name/Company Name:
* Address: * Street number:

* City:

Pick up data

After:

*Openings hours:

* Contacts:

* Phone:

* E-mail:

Number of parcel

Weight

Length

Width

Height
cm

Volume
m 3

Pype

Stackable Pallet

Total:

Kg

      

m3

    

Destination

* Country:

* City:

* ZIP:

Notes:
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I declare that I have read the Privacy Policy in which I certify that Euronord is the owner of "CUSTOMER DATA" for the purpose of managing the service. I also declare that I am aware of the fact that Euronord International processes the data entered in the "PICK UP DATA" and "DESTINATION" fields of this form, as manager.