Modulo iscrizione inglese | AV Eventi e Formazione srl

MODULO ISCRIZIONE PAGAMENTO INGLESE

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First Name *

Last Name *

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Birth place *

Birth date *

Residence place *

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Province / State / Nation *

Postal Code *

Main Phone *

Mobile Phone *

E-mail *

Profession *

Specialization *

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Course / Congress / Event name *

Course start date *

Course end date *

Payment in € *

CRO Number *

Invoice holder *

Street / Road / Avenue / Square / ecc., number *

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Country, State *

VAT Number / Fiscal Code *

Recipient code / PEC *

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