car

Automotive Technology Centre

Steenovenweg 1
P.O. Box 1015 MC
5700 MC Helmond

T +31 (0)492 562 520
F +31 (0)492 562 529
E info@atcentre.nl

Registration as a Partner or Member of ATC

  1. Registration as Partner or member of ATC
  2. Contact Person(*)
    Please fill in the full name of the contact person.
  3. Organization(*)
    Please fill in the name of your Organization
  4. Invoice address(*)
    Please fill in the address for the invoice (if appliccable)
  5. ZIP code(*)
    Please fill in the zip code corresponding with the invoice address.
  6. City(*)
    Please fill in the city corresponding with the invoice address.
  7. E-mail(*)
    Please fill in the email address of the participant.
  8. Phone(*)
    Please fill in the phone number of the participant.
  9. Registration Details
    All costs are excluding 19% VAT.
  10. Registration Costs(*)



    Please select one of the options.
  11. If your company requires a Purchase Order Number for the invoice, you can fill it in here.
  12. Purchase Order Number
    Invalid Input