Modulo Richiesta Tessera Sconti

RICHIESTA/RINNOVO TESSERA DI F1SOFTWARE

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Data*

Classe Tesserato F1Software*

Nuovo Tesserato BASE(€ 105,00)Rinnovo Annuale Tessera BASE(€ 100,00)Nuovo Tesserato PLUS(€ 156,00)Rinnovo Annuale Tessera PLUS (€ 150,00)

I MIEI DATI

Nome*

Cognome*

La tua email*

Telefono Mobile*

Indirizzo*

Numero Civico*

Codice di avviamento postale (CAP)*

Città*

Provincia*

Oggetto*

Dati del/dei Computer

Marca e Modello dei miei Computer*

DATI PAGAMENTO QUOTA

Stato del Mio Pagamento:*

ho già effettuato il pagamento della cifra a voi dovutaeffettuerò il pagamento a voi dovuto tramite questo sitonon mi è chiaro come effettuare il pagamento, vorrei essere contattato per maggiori delucidazioni.

Estremi e Descrizione Modalità di Pagamento*

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