Registration form

To become a member of the Dutch Moldovan Business Council, please complete this registration form.

Company information

Company Name (required)

Address line 1 (required)

Address line 2

City (required)

Postal Code (required)

Country (required)

Company activities (required)

Sector (required)

Contact person (required)

Website adress (required)

Personal information

First name (required)

Last name (required)

Telephone (required)

Mobile phone

Email adress (required)

In which sectors are you interested?

Reasons of interest?