AHD, HD-CVI, HD-TVI, HD-SDI, CCTV


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Form for the New Customers

If you are a New Customer in our store, please to register first. The Registration consists in entering your data into the form below. This is necessary so that we know to whom to send the goods and who will pay for them.

The Registration allows you also to place the next orders without necessary enter your data again. Just remember your Id (Login) and Password. Besides, each registered customer has a possibility to keep track the current status and history of all orders you have previously made.

The data necessary for next logins (Remember!)
Login:	*
Password:	*
Password (enter again to verify):	*

Data for the Sales Document (you can add other shipping address during checkout finalizing step)
-Comapany -Private
Company Name:	*
Vat No.:
Access to the Wholesale Prices:	I am a company from the industry and I ask for access to wholesale pricing (wholesale customer status will be assigned by the administrator after verification of the company)
Street & Number:	*
City:	*
Postal code:	*
Country:

Contact information to the person placing the oder

Surname:

Name:

E-mail:

Mobile Phone No. for SMS notification:

(+)

Contact Phone No.:

I order quarterly information about new products:

Type the code shown in the picture:


			*

The order with the obligation of payment. I have read and accept the Store Regulations and Privacy Policy of the Delta-Opti store and consent to the use and processing of my personal data for the purpose of implementation of the orders (according to the Act on Protection of Personal Data as of August 29, 1997). *

* - Required fields