© 2003 JPSCORKgroup



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Registration in individual name
Personal Data
* Name:  
* Address:  
* Postcode:  
* Town/City:  
* Country:  
* Telephone.:  
Fax:  
e-mail:  
URL:  
* Age:  
Profession:  
Field of activity:  
Please select all options that apply to your case:
I work or have worked for a company that distributes cork products.
I work or have worked for a wine-bottling company.
I work or have worked for a company that distributes products linked to the wine industry
     (corks, barrels, filters, bottles, labels, bottling machines, etc)
I live in a zone where there are many companies with potential interest in cork products.
I have already visited at least one company that produces cork products.
Observations: