Identification form

To offer a better service, we would be grateful if you would fill in this application form.
The requested information is necessary to create your account on our computer system.
We thank you for helping us to improve the quality of our service.

Company * :
Activity :
Name * :
First name :
Post :
Adress :
Postal code :
City :
Country :
Telephon number * :
Fax :
E-mail* :
How id you find our website : (google, documentations ...)
Which range of product are you interested in ? What particular kind of product * ?
* : Compulsory
Which application would you send us ? Enquiry Password to download documentations.       (user manuals, calculations ...) Comments about our website
Your message :

You're likely to receive commercial offers from our company for products and services similar to those you have ordered. If you do not want to, check the box cons:

The information transmitted via this site is intended for Acim Jouanin and will under no circumstances be communicated to third parties.
You have a right to access, modify, rectify and delete data concerning you.
To exercise this right, please contact ACIM Jouanin - ZI n ° 1 - 650 Rue Vulcain - BP 1725 - 27017 Evreux Cedex