TORQEEDO DISTRIBUTOR REQUEST FORM Supplier Carré SPRL Rue des Anthémis 10 5100 WEPION BELGIQUE Contact Jean-Pierre Masquelier +32 81 46 05 45 +32 497 54 49 53 Distributor Company : Name : Adress : Code + city : Country : Phone : Website : E-mail : ACTIVITE : Reasons for sale TORQEEDO : Thank you for your cooperation, we will contact you.