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Application form for participation in MPS-ABC

Name of nursery *

Chamber of Commerce nr *Add a copy of an extract of the Chamber of Commerce.

Valid extract of your registration at the Chamber of Commerce

No file chosen

VAT-number *

Contactperson *First and last name

E-mail *

Telephone *

Mobile phone number

Postal address

Postal address *

City

Postal code

Country

Cultivation data *

Bedding plants/perennialsBulb growingCut flowersFruit/VegetablesNursery stock cropsParental materialPot plantsOtherPlease fill in your cultivation(s)

Total surface indoor crops (m2) *

Total surface outdoor crops (m2) *Surface excluding arable farming

Number of locations *If you have more than one location please fill out the address details of the other locations

Visiting address

Visiting address *

City

Postal code

Visiting address location 2

Location 2

City

Postal code

Visiting address location 3

Location 3

City

Postal code

Member of a Dutch Flower auctionYesNo

Name of auction

Your auction number

Other membershipsYesNo

Name of institutions

Membership number

Have you participated in MPS-ABC before? *YesNo

MPS-number

Record-keeping starting date *

Reason for application *We would like to know your reason for application for MPS-ABC. This could be: take responsibility, additional value, market demand, etc. And if it is market demand could you please mention which party is asking for it?

Would you like to sign up for our monthly digital newsletter?YesNo

Remarks

PaymentWe would like to pay via Direct Debit AgreementWe would like to pay via Direct Debit Agreement (debiting via FloraHolland auction)We would like to pay via invoice

IBAN *

If you choose to authorize via the auction, please complete this form and e-mail it to info@my-mps.com.

Reference (purchase order)If you have your own reference for the invoice, you can indicate this here.

Comment

GDPR *

Yes, I agree with the terms and conditions of MPS-ABC.

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Contact

Visiting address
Middel Broekweg 29
2675 KB Honselersdijk

Postal address
P.O. Box 114
2678 ZJ De Lier

T +31 (0)174 – 615 715
E info@my-mps.com

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