FORMULARI D'INSCRIPCIÓ A LA SAM
Nom *
Your answer
Cognoms *
Your answer
Data de naixement *
ex: XX/YY/ZZZZ
Your answer
DNI *
ex: 12345678A
Your answer
Adreça *
ex: C/ Pau Casals 25
Your answer
Població *
ex: Tremp
Your answer
CP *
ex: 25620
Your answer
Telefon *
ex: 97365XXXX
Your answer
Un altre telèfon
Your answer
Your answer
Quota de soci *
Quota anual, i quota d'ingrés gratuïta
Codi IBAN *
IBAN ES06 9000 0001 2101 2345 6789
Your answer
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