Ports Agents - Logistics

APPLICATION FORM

Please make sure you complete all the Fields below to process your application on time:

Company Name*

Business Type: LLC, Corp, Single owner etc.*

Main office address*

City*

State*

Country*

Zip Code*

Primary Contact*

Title*

Telephone*

Cell phone*

E-mail*

Accounting contact name*

Email*

Phone number or extension

Website

Additional locations

Year business was stablished

Are you part of other networks? Please list them

LICENSES AND CERTIFICATIONS

Please select the licenses and certifications you have.

*Please submit a copy front and back of your certifications mentioned above

COMPANY OWNERSHIP

Name*

Percent Owned*

Name*

Percent Owned*

Name*

Percent Owned*

Capitalization

Currency

AFFILIATIONS

Please list any other private trade groups to which you below:

FREIGHT FORWARDERS REFERENCES

Please provide one reference per country of companies you have worked with:

1 Reference

Please mention the following reference data: Type of Business /Contact /City /Country /Phone /Email /Website

2 Reference

Please mention the following reference data: Type of Business /Contact /City /Country /Phone /Email /Website

3 Reference

Please mention the following reference data: Type of Business /Contact /City /Country /Phone /Email /Website

APPLICATION FORM

Please make sure you complete all the Fields below to process your application on time:

LICENSES AND CERTIFICATIONS

COMPANY OWNERSHIP

AFFILIATIONS

FREIGHT FORWARDERS REFERENCES

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