Epic App

You are a provider of social, music or video App and would like to participate to the Epic Offer, fill in the form here under.

Only 1 App per application form.

Alle velden zijn verplicht, behalve die waar "optioneel" staat.

back IsFirstStep: {{isFirstStep()}} CurrentStep: {{getCurrentStep().index}} {{getCurrentStep().title}} TotalSteps: {{totalSteps}} IsLastStep: {{isLastStep()}} next

Company

Company name {{errorMessages.companyname.required}} {{errorMessages.companyname.pattern}} {{errorMessages.companyname.pattern}} {{errorMessages.companyname}}

Enterprise number {{errorMessages.vat.required}} {{errorMessages.vat.pattern}} {{errorMessages.vat.pattern}} {{errorMessages.vat}}

Street name {{errorMessages.street.required}} {{errorMessages.street.pattern}} {{errorMessages.street.pattern}} {{errorMessages.street}}

Number {{errorMessages.number.required}} {{errorMessages.number.pattern}} {{errorMessages.number.pattern}} {{errorMessages.number}}

Box (optioneel) {{errorMessages.box.required}} {{errorMessages.box.pattern}} {{errorMessages.box.pattern}} {{errorMessages.box}}

Zipcode {{errorMessages.zipcode.required}} {{errorMessages.zipcode.pattern}} {{errorMessages.zipcode.pattern}} {{errorMessages.zipcode}}

City {{errorMessages.city.required}} {{errorMessages.city.pattern}} {{errorMessages.city.pattern}} {{errorMessages.city}}

Contactpersonen

Commercial contact person

Voornaam {{errorMessages.firstname.required}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname}}

Achternaam {{errorMessages.lasttname.required}} {{errorMessages.lasttname.pattern}} {{errorMessages.lasttname.pattern}} {{errorMessages.lasttname}}

E-mailadres {{errorMessages.email.required}} {{errorMessages.email.pattern}} {{errorMessages.email.pattern}} {{errorMessages.email}}

Countrycode eg +32 {{errorMessages.countrycode.required}} {{errorMessages.countrycode.pattern}} {{errorMessages.countrycode.pattern}} {{errorMessages.countrycode}}

Telefoon {{errorMessages.telefoon.required}} {{errorMessages.telefoon.pattern}} {{errorMessages.telefoon.pattern}} {{errorMessages.telefoon}}

Technisch contactpersoon

Is de technische contactpersoon dezelfde persoon als de algemene contactpersoon ? {{errorMessages.same.required}} {{errorMessages.same.pattern}}

Voornaam technisch contactpersoon {{errorMessages.firstname2.required}} {{errorMessages.firstname2.pattern}} {{errorMessages.firstname2.pattern}} {{errorMessages.firstname2}}

Achternaam technisch contactpersoon {{errorMessages.name2.required}} {{errorMessages.name2.pattern}} {{errorMessages.name2.pattern}} {{errorMessages.name2}}

E-mailadres technisch contactpersoon {{errorMessages.emailtech.required}} {{errorMessages.emailtech.pattern}} {{errorMessages.emailtech.pattern}} {{errorMessages.emailtech}}

Achternaam technisch contactpersoon {{errorMessages.countrycodetech.required}} {{errorMessages.countrycodetech.pattern}} {{errorMessages.countrycodetech.pattern}} {{errorMessages.countrycodetech}}

Telefoon technisch contactpersoon {{errorMessages.telefoontech.required}} {{errorMessages.telefoontech.pattern}} {{errorMessages.telefoontech.pattern}} {{errorMessages.telefoontech}}

Company

Name of the app (store name) {{errorMessages.appname.required}} {{errorMessages.appname.pattern}} {{errorMessages.appname.pattern}} {{errorMessages.appname}}

App category Social Music Video

Description of your app {{errorMessages.description.required}} {{errorMessages.description.pattern}} {{errorMessages.description.pattern}} {{errorMessages.description}}

Link to the app in App Store {{errorMessages.appstore.required}} {{errorMessages.appstore.pattern}} {{errorMessages.appstore.pattern}} {{errorMessages.appstore}}

Link to the app in Play Store {{errorMessages.playstore.required}} {{errorMessages.playstore.pattern}} {{errorMessages.playstore.pattern}} {{errorMessages.playstore}}

Company

P2P protocol (optioneel) {{errorMessages.p2pprotocol.required}} {{errorMessages.p2pprotocol.pattern}} {{errorMessages.p2pprotocol.pattern}} {{errorMessages.p2pprotocol}}

IP address of the server {{errorMessages.ip.required}} {{errorMessages.ip.pattern}} {{errorMessages.ip.pattern}} {{errorMessages.ip}}

Domain name used by the service {{errorMessages.domain.required}} {{errorMessages.domain.pattern}}

SNI (for HTTPS) (optioneel) {{errorMessages.sni.required}} {{errorMessages.sni.pattern}} {{errorMessages.sni.pattern}} {{errorMessages.sni}}

Protocols (optioneel) {{errorMessages.protocols.required}} {{errorMessages.protocols.pattern}} {{errorMessages.protocols.pattern}} {{errorMessages.protocols}}

URL lists (optioneel) {{errorMessages.url.required}} {{errorMessages.url.pattern}} {{errorMessages.url.pattern}} {{errorMessages.url}}

Portnumbers (optioneel) {{errorMessages.portnumbers.required}} {{errorMessages.portnumbers.pattern}} {{errorMessages.portnumbers.pattern}} {{errorMessages.portnumbers}}

Company

I have read and agreed with the General Terms & Conditions for the participation of the Content Partner in the Epic Zero Rating Offer of Proximus SA

Proximus mag mijn persoonsgegevens registreren in zijn bestanden en me contacteren, ook per telefoon en via elektronische kanalen zoals e-mail, sms of sociale media. Proximus mag mijn gegevens delen met zijn filiaal Scarlet. Ik weet dat mijn gegevens verwerkt worden volgens het privacybeleid van Proximus, dat ook uitlegt hoe ik mijn privacy-instellingen kan aanpassen.

Epic App

Company

Contactpersonen

Commercial contact person

Technisch contactpersoon

Company

Company

Company

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Stel ze aan een van onze medewerkers. Maak een keuze:

Je vindt ons op

Epic App

Company

Contactpersonen

Commercial contact person

Technisch contactpersoon

Company

Company

Company

Even geduld, je gegevens worden verwerkt

Je vindt ons op