I request the Company Profile Service (CPS)
Last Names: *
First Name: *
Job Title: *
Company: *
Address: *
Country:  *
State: *
City: *
Zip Code: *
Phone: *
Cell:
Email: *
Web:
Industry Sector of your Company: *
--------------------------------------------------------------------------------------------------------------
Information of the Profile Service Company:
Company Name: *
Address: *
District / Zip Code: *
Department: *
Telephone: *
Contact Name: *
Contact Job Title: *
Additional Information:
--------------------------------------------------------------------------------------------------------------
Method of payment
Wire Transfer in U.S. Dollars
Bank: INTERBANK
Carlos Villaran 150 - Urb. Santa Catalina - Lima 13, Peru
Tel:  (511)  219-2000
Account: 059-001032046-9
Owner: Thais Corporation S.A.C.
Swift: BINPPEPL
Credit Card
Credit Card:
Expiry Date:
Card Nº: - - - -
The last three numbers of the card are listed at the back of the card next to the signature.
Owner Card:
Security Code: *