Organization information

We would like to know who you are

Organization name
Registration number
Vat number
Global Location Number (GLN) (optional)
Currency
Timezone
Address
Address 2 (optional)
Postal code
State/Region (optional)
City
Country

Contact Information

How to reach you in case we need to

Name
Phone
Email
Email for EDI issues

Invoice Information

Where you, as a customer, receive invoices

E-mail
Name (optional)
Reference (optional)
Address (optional)
Address 2 (optional)
Postal code (optional)
City (optional)

Agreement Contact

E-mail
Name
Phone (optional)
Approver name (optional)
Approver Email (optional)

Login Credentials

Login credentials to GoldenEDI Portal

Name
E-mail
Password
Repeat Password