Supplier Registration

Form for Prospective Suppliers

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* Fields marked with an asterisk are mandatory

General Company Information

Company Name:

Language:

Homepage:

Tax Jurisdiction Code:

Currency:

Title:

Tax Number Type:

Tax Number:

Tax type:

Address

Country:

Region:

District:

City: / Postal Code:

House Number: / Street:

Building: / Floor: / Room:

Detalles de la empresa (Solo para Argentina / Only for Argentina)

Área donde podría brindar servicio

Refinería Campana

Bs As (CABA)

Terminal Galvan – Bs As

Neuquén

Terminal San Lorenzo – Santa Fe

Salta

Chubut

Santa Cruz

NOA(Litio)

Otros

Seleccione la cámara empresarial a la que pertenece (solo si aplica):

ACIPAN

CEIPA

CAPESPE

ADINEU

CAMARCO

CAPMIN

GAPP

Camara GOLFO

CUCEI

UIC

CIQYP

UEJ

UIJ

CASEMI

CMJ

CAPEMISA

UICA

CIMA

CAPIPE

CAPPROMIN

CASEMICA

Communication

Phone Number: / Extension:

Fax Number: / Extension:

E-Mail:

Contact Details

Title:

First Name:

Last Name:

Academic Title:

Department:

Function:

Phone Number: / Extension:

Fax Number: / Extension:

E-Mail:

Language:

Country:

Product Categories *

THE CATEGORIES CHOSEN AND SUBSCRIBED BELOW WILL BE TAKEN INTO ACCOUNT FOR FUTURE PURCHASES

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Attachments

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