Wholesale Account Agreement

Do you want approval to sell Blackboard through the internet?
YesNo

Would you like to be listed in the Blackboard locator service on our website?
YesNo

Shipping Address (If different from above)

Do you sell other orthotic products?
YesNo

Do you would like to get videos and publicity to actively promote the BlackBoard.
YesNo

I noted that the recommended Minimum Advertised Price of the BlackBoard is 109,- Euro*
I agree that the minimum commercial order is 10 pices.*
I have read and agreed to the Terms and Conditions.*
I agree with the privacy policy.*