Register form of Nisgav for User and Password

New User register for access of the price pages, for opticians, agents and wholsalers only !

New User, request for username and password

Register as New User of Nisgav International Trading and we will send your username and password to access prices and other info.

	Company Name
	Contact Person
	Street Address
	Zip Code, Post Code
	City
	Country
	Telephone Nr.
	Fax Nr.
	E Mail
	BTW nr., V.A.T. nr., TVA
	Remarks
	Contact me by Phone, E Mail or Fax

You can also call: +31- (0) 653-160118:

Fax: +31- (0) 180-623562

or Post to:

Nisgav-Optics, P.O.Box 4344, 3006 AH, Rotterdam, Holland.