CUSTOMER REGISTRATION FORM

Date :
Basic customer information:

City State: ____________________________________________

ID / RIF ________________________

Name or Social reason: _____________________________________________

Primary residence address: _______________________________________

_________________________________________________________________

Profession or occupation: _______________________________

Telephone No. ________________________ Cell phone:

_______________________

Email 1: __________________________________

Interest in our products:

Solar energy
Wind power
Hybrid Inverters
Lightning
High, Medium and Low voltage products
Transformers
Others (indicate): _______________________________________