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Register as a new customer

Wageningen Bioveterinary Research (WBVR) is glad to welcome you as a new customer. Before we can examine your samples for animal diseases, we first ask for your data.

Want to receive a discount?

Via the form below you can also indicate whether you want to make use of the direct debit option. In that case, you will receive a 2% discount on our services.

Your data

Company name

i

Name*

First name*

Last name*

Address*

Street*

Housenumber*

PC and city*

Postal code*

City*

Country*

Email*

Phone number*

VAT-number

i

Chamber of Commerce number

Is the invoice address the same as above*

Yes No

Address*

Street*

Housenumber*

PC and city*

Postal code*

City*

Country*

Would you like to use direct debit option to receive a 2% discount*

Yes No

IBAN-account number*

I would like to receive the newsletter with the latest news on diagnostics

Yes

Privacy*

I agree with the use of my personal data for the purpose detailed above. The privacy statement of WUR applies to this use of your personal data.

Read the privacy statement

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