Discover our Bring
a Friend campaign

Please leave this field empty.

Your own contact details

Salutation*

SirMadam​

First name*

Last name*

MID Axepta*

You'll find your MID number on a sales ticket, your daily overviews, myPortal ... Your MID begins with 6xxxx.

E-mail address*

Phone number*

Your company*

Your company number*

Next

Your friend's contact details

Salutation*

SirMadam​

First name*

Last name*

Name of the company*

E-mail address*

Phone number*

Company number*

By providing the personal data of third parties, you assure Axepta that you have obtained their consent. Accept the terms and conditions.

The personal data mentioned above are processed by Axepta BNP Paribas Benelux NV/SA, as the controller, in accordance with its Privacy Statement available on axepta.be. It will only be used for the proper conduct of the bring a friend campaign. For more details about your rights and obligations, see paragraphs 3 and 8 of the Privacy Statement.