Corso Trial 1 Livello | Asi Torino

Corso Trial 1 Livello

Selezione data del corso *

Seleziona la data d'interesse. In assenza di date selezionare la casella "data da definirsi" Verrete ricontattati il prima possibile.

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 *

Indicare il recapito dove si vuole essere contattati

Email *

Associazione di appartenenza *

Carica Ricevuta Bancaria

Fai clic o trascina il file su quest'area per caricarlo.

IBAN IT10N0335901600100000009167 Causale: Nome Associazione

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