Φόρμα Παραγγελίας / Order Form


Επωνυμία / Name:                                                 

Όνομα σκάφους / Yacht name:                               

Επάγγελμα / Profession:                                        

Διεύθυνση / Address:                                             

Πόλη / City:                                                            

Τ.Κ. / Post Code:                                                     

Τηλέφωνο / Phone:                                                 

Κινητό / Mobile:                                                     

Fax:                                                                        

E-mail:                                                                   

ΑΦΜ / Tax Identification Number:                           

Δ.Ο.Υ. / Tax Office:                                                  

Oνοματεπώνυμο υπεύθυνου / Owner full name:     

Επιθυμώ να παραγγείλω / Wish to Order:


Diesel κίνησης σκαφών / Yachts Fuel

Σημείο παράδοσης / delivery point:                        

Επιθυμητή Ημερομηνία Παραλαβής / Desired Pickup Date:                       

Επιθυμητή Ώρα Παραλαβής / Desired Pickup Time:                                  

Τρόπος πληρωμής / Payment:                            Αντικαταβολή / Cash on delivery
                                                                            Κάρτα / Card