Corso Danza 1 Livello | Asi Torino

Corso Danza 1 Livello

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Selezione data del corso

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Nome

Nome

Cognome

Tessera Asi

SI
NO

Numero Tessera ASI

nel caso si abbia tessera asi in corso di validità indicarne il numero

Indirizzo di residenza

Indirizzo (linea 1)

Località

Stato / Provincia / Regione

Codice postale

Nazione

Codice Fiscale

Data di nascita

Luogo di nascita

Telefono

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Email

Associazione di appartenenza

Carica Ricevuta Bancaria

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IBAN IT10N0335901600100000009167 Causale: Nome Associazione

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