Stage Varium 2019
22-25/07/2019
Nom Cognom/ Nombre Apellidos/ Prenom et nom/ Name and Surname *
Data de Naixement/ Fecha de nacimiento/ Date de Naissance/ Date of birth *
Ciutat·Pais/ Ciudad·Pais/ Ville·Pais/ City·Country *
Telèfon/ Teléfono/ Teléphone/ Telephone *
Mail *
Cursos/ Courses *
Required
Preus/ Precios/Prices/ Prix *
Adjuntar comprovant de la reserva 30€/ Adjuntar comprobante de la reserva 30€/ Joindre une preuve de paiement 30€/ Attach the payment receipt 30€ *
Required
Accepto la normativa/ Acepto la normativa/ j'accepte le règlement/ I accept the regulations *
Required
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