Request for subscription
Company / Organization
Director's last name
Director's first name
SEPA Direct Debit
forfait eborn+ 35€/month/tag
Nb of vehicles in the fleet
Abonnement des professionnels :
Montant total de votre abonnement :
Contact / Administrator duly authorized to carry out the registration
Address of the fleet corresponding to SIRET
Number and street
I certify I have the authority to engage my business in a legal and financial level.
Please certify that you have the authority to engage your business in a legal and financial level.
I've read and I accept the general utilisation conditions (available on the public portal) of the electric vehicles recharge service.
Please confirm that you've read the general utilisation conditions (available on the public portal) of the electric vehicles recharge service.
I've read the terms and conditions for subscribing to the electric vehicle charging service, which I wish to register. I agree to pay the subscription fee of
Please confirm that you've read the conditions of subscription to the electric vehicles recharge service and that you accept to proceed to the payment of the subscription fees.