CLIENT CARD APPLICATION FORM
Only with Promo Cash&Carry card:
  • Buy products with discounts.
  • Participate in special promotional campaigns for card holders.
  • If desired get emails about our best offers.

For more information please contact:

+370 37 401155
cash.carry@sanitex.eu

I NEED

Company's data

Can not be empty

Can not be empty

Must be 6-11 symbols

Must be 2 letters and 9 or 12 numbers

Only numbers can be used

Duomenys apie veiklą

Can not be empty

Only numbers can be used

Can not be empty

Can not be empty

Invalid date format

Can not be empty

Must be 2 letters and 9 or %q% numbers

Company's main activity:

Can not be empty

Can not be empty

Company's juridical address

Company legal address

Can not be empty

Only numbers can be used

Must be 5 or %q% or %p% numbers

Can not be empty

Can not be empty

Company's delivery address

Can not be empty

Only numbers can be used

Must be 5 or %q% or %p% numbers

Can not be empty

Can not be empty

Add one more delivery address

Card holder’s data

Can not be empty

Can not be empty

Please enter a valid email

Can not be empty

Only numbers can be used


Person applying for the card

Can not be empty

Can not be empty

Can not be empty

Other information

Can not be empty