http://www.glocentra.com/formtest.htm

Add your company, product or service to GLOCENTRA Listing and Directory is easy

Ajouter votre compagnie, produit ou service a GLOCENTRA Annuaire est facile a faire

1 - Company Contact (Required Fields*):

*Company Name (): Nom de la Compagnie:**
Web Site/URL:
*Email Address (): Adresse de la Messagerie Electronique:**
Contact Name: Nom de Famille et Prénom du Responsable:
Contact Title/Position: Poste et Titre du Responsable:
*Telephone Number (): Numéro de Telephone ():*
Toll Free Phone Number: (if any)
Fax Number: Numéro du Facsimile/Fax:
Toll Free Fax Number: (if any)
*Company Address (): Adresse de la Compagnie ():*

*City (): Ville ():*
*State () [for USA/Canada/Mexico/UK]: Province ():*
Country: Pays:
*Zip/Postal Code (): Code Postale ():*

2 - Company Ad Contact:

2 - Directe Contact dans la Compagnie:

This personal contact info will not be posted if different from above Les indications fournies ci-dessous ne seront pas publiées si elles different de celles données en haut
*Your Contact Name (): Votre Nom ():*
Your Contact Title/Position: Votre Poste et Titre:
*Your Contact Email Address(): Votre Messagerie Electronique:**
Your Phone/votre Té*lephone ():**
Your Personal Phone Extension: (if any): Votre Directe Ligne Té*lephonique ():**

Step 3 - Select the Targeted Region/Country for your Operations and your Type of Business:

Etape 3 - Choisissez la Région / Pays Ciblé par vos Opérations et par Vos Affaires:

a) Select Region or Country of your interest where GLOCENTRA will assist you in your trade,

business and marketing or advertising operations.

a) Choisissez la région ou le pays de votre préference ou GLOCENTRA pourrait vous aider à réaliser

vos affaires, vos échanges commerciaux ou votre campagne publicitaire.

Regional Resources:

Région d'Opération:

Asia:

Australia, New Zealand and Oceania:

Europe:

Latin America and Caribbean:

North America:

North Sahara/Sub-Saharan Africa

& Middle East:

b) Mark the box which is the most defining your activity or business operation. If you have

several services and products, please check all the multiple corresponding boxes or use the

space provided below to add more inputs and description of your company, product, market

and customers:

b) Choisissez et marquer les petites cases qui conviennent le plus à votre affaire ou pouvant le

mieux decrire vos opérations. Vous pouvez aussi ajouter des indications supplementaires sur

votre affaire en les ecrivant dans l'encadrement fournie ici-bas pour votre convenience:

Paid Listing

Enregistrement Payant

Free Listing

Enregistrement Non-Payant

Exporter
Importer

Trading Company / ExporterTrading Company / Import

Freight-Forwarder
Maritime/Air/Freight-Insurance

Food Oriented Product
Consumer Goods

Manufactured Goods
Medical Equipment & Systems

Textile
Leather

Manufacturer

Dealer/Retailer/Supplier
Used Parts Buyer / Liquidator

Used Parts Liquidator

New Surplus Parts Liquidator
New Surplus Parts Buyer / Liquidator

Bank/Letter of Credit Issuer

Educational/Training
Software Developer/Vendor
International / Marketing / Advertising

Cooperative
International Trade/ Copyright / Business / Law Firm

International Trade/Business Consulting
Media/Periodical/Newspaper/Magazine.

Non-Profit Association / Industry User Group
Government / Regulatory Body

E-Commerce Web Site
(Non-Profit) Resource Web Site
(Non-Profit) Industry Web Site

Other:

Not finding a category above or would like to tell us more about your company, product, market, and customers, please use the space provided below:

Where did you first hear about GLOCENTRA?

Source Description:

Please contact me as soon as possible regarding this matter.

THANK YOU FOR YOUR CONSIDERATION

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