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Company name*

Title

Mr. Mrs. Ms.

Holder / Chair Man*

Street*

Postcode*

City*

Cooperation

Membership number

Title

Mr Mrs Ms

First name*

Surname*

Telephone*

Fax*

E-mail*

Department*

Function / Position*:

Desired Password*:

(Regard: not less than 6 characters, maximal 30 character, alpha numeric, that means, letters and numbers)

Hama Customer Number*:

(Regard: Several Customer Numbers possible)

Your Hama Representative:

Data Security Delcaration:

We promise to save your personal data only for dealing with your correspondence or order. We ensure that no other party is able to receive your personal data. For more information about data security please read the Corporate Information & Privacy Policy.

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