Register to e-Services

I am interested in registering on behalf of my company to transact business online with Proximus Wholesale.
I am an employee of the company and I am authorized by my company to make this request. :

Register to our e-Services to benefit from the various range of online e-Tools & applications. By using the registration form below, you can select the different e-Services to which you need access to. Our Customer support will then register your request and you will receive your personalised login and password on the email address provided by you.

Tous les champs sont obligatoires, sauf ceux mentionnés comme "facultatifs".

Your data

Please fill in the following information to create your e-account

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{{errorMessages.firstname.required}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname}} {{errorMessages.firstname.pattern}}
{{errorMessages.name.required}} {{errorMessages.name.pattern}} {{errorMessages.name.pattern}} {{errorMessages.name.pattern}} {{errorMessages.name}} {{errorMessages.name.pattern}}
{{errorMessages.email.required}} {{errorMessages.email.pattern}} {{errorMessages.email.pattern}} {{errorMessages.email.pattern}} {{errorMessages.email}} {{errorMessages.email.pattern}}
{{errorMessages.phone.required}} {{errorMessages.phone.pattern}}
eg. +32 2 123 45 67 {{errorMessages.fixed.required}} {{errorMessages.fixed.pattern}} {{errorMessages.fixed.pattern}} {{errorMessages.fixed.pattern}} {{errorMessages.fixed}} {{errorMessages.fixed.pattern}}
eg. +32 471 23 45 67 {{errorMessages.mobile.required}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile}} {{errorMessages.mobile.pattern}}
{{errorMessages.company.required}} {{errorMessages.company.pattern}} {{errorMessages.company.pattern}} {{errorMessages.company.pattern}} {{errorMessages.company}} {{errorMessages.company.pattern}}
{{errorMessages.cust_id.required}} {{errorMessages.cust_id.pattern}} {{errorMessages.cust_id.pattern}} {{errorMessages.cust_id.pattern}} {{errorMessages.cust_id}} {{errorMessages.cust_id.pattern}}
{{errorMessages.login.required}} {{errorMessages.login.pattern}} {{errorMessages.login.pattern}} {{errorMessages.login.pattern}} {{errorMessages.login}} {{errorMessages.login.pattern}}

Your selection

Please select the e-Services for which you would like to register.
If you already have a login, then please select only the new e-Services to be added to your account.

Pre-Checks and Ordering (facultatif)
{{errorMessages.prechecks_and_ordering.required}} {{errorMessages.prechecks_and_ordering.pattern}}
{{errorMessages.prechecks_and_ordering.required}} {{errorMessages.prechecks_and_ordering.pattern}}
{{errorMessages.prechecks_and_ordering.required}} {{errorMessages.prechecks_and_ordering.pattern}}
{{errorMessages.prechecks_and_ordering.required}} {{errorMessages.prechecks_and_ordering.pattern}}
e-Care (facultatif)
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
{{errorMessages.ecare.required}} {{errorMessages.ecare.pattern}}
e-Billing (facultatif)
{{errorMessages.ebilling.required}} {{errorMessages.ebilling.pattern}}
Regulatory Content (facultatif)
{{errorMessages.regulatory_content.required}} {{errorMessages.regulatory_content.pattern}}

By registering, I confirm I am authorized by my company to subscribe to the Proximus e-Services. The use of the e-Services will be governed by the General Terms and Conditions MyPersonalPage for Wholesale customers. *

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Envoyer

Veuillez patienter quelques instants, vos données sont en cours de traitement

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