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Project request

Project request

Please fill in the request form as detailed as possible.

We will deal with your request soon and contact you as soon as possible.

If you have any questions, please send an Email to PM@scansourcecommunications.de.

*By filling in the request form you approve ScanSource Communications to save and deal with your data. The transfer of your data to a third party is not allowed. The terms and conditions are to be applied.

Company/Reseller*
Subject*
First Name*
Last Name*
Title - business card*
Function/Department*
Street*
Zip code/Place*
E-Mail*
Telefon
Fax

End customer*
Street*
Zip code/City*
contact*
Telefon*
E-Mail*

Manufacturer*
Contactpartner manufacturer
Probability of project in %*
Installation date with the End-customer
Date final customer order assignment
Date final Reseller order assignment
Date final distributor order assignment
Public advertisement	ja nein
Limited advertisement	ja nein
Contract of the final customer	ja nein
Alternative product desired	ja nein
Note to the project

Article numbers/quantity
Necessary Discount in %

Company/competitor*
Price level competitor*
Product/price competitor*

Note