MARIANA MONTES seminar booking 21-22 September 2024

1. FOLLOWER:
2. Name(obligatory)
3. Surname(obligatory)
4. Associate No, I'm not associated and I ask to be to participateYes, I am associated with ACSI with the data belowYes, I am associated with LIBERTAS with the data belowYes, I am associated with FIDS with the data below(obligatory)
5. Card number
6. Card issue date
7. Card issuer association
8. Telephone number(obligatory)
9. Email address
10. Facebook contact
11. PartnerYES, I have a partner for lessonsNO, I don't have a partner for lessons
12. PARTNER :
13. Name
14. Surname
15. AssociateNo, I'm not associated and I ask to be to participateYes, I am associated with ACSI with the data belowYes, I am associated with LIBERTAS with the data belowYes, I am associated with FIDS with the data below
16. Card number
17. Card issue date
18. Card issuer association
19. Telephone number
20. Email address
21. Facebook contact
22. ASSOCIATIVE CONTRIBUTIONS FOR LESSONS:
    1 lesson 30.00 €
    2 lessons 55.00 €
    3 lessons 75.00 €
    4 lessons 95.00 € (including Saturday evening)
    5 lessons 115.00 € (including Saturday evening)
    6 lessons 135.00 € (including Saturday evening)
    (the associative contributions indicated are for single associate)
23. RESERVATION of SATURDAY LESSONS
24. Lesson N. 1
25. Lesson N. 2
26. Lesson N. 3
27. Lesson N. 4
28. RESERVATION of SUNDAY LESSONS
29. Lesson N. 5
30. Lesson N. 6
31. The sending of this form implies consent to the processing of personal data pursuant to EU Regulation no. 2016/679.
32. Leggi l'informativa completa
33. The didactic activity is aimed at all ACSI.
34. For your safety, write the result of the underlying operation in the white space (eg: 10-6 write 4)
35. 24:6