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FICHA DE ADESÃO – SÓCIO COLABORADOR
MENSALIDADE: R$ 570,11
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DADOS DA EMPRESA
SEGMENTO:
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RAZÃO SOCIAL:
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ENDEREÇO:
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BAIRRO:
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CIDADE:
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ESTADO:
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CEP:
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CNPJ:
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TELEFONE:
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SITE:
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INSCRIÇÃO ESTADUAL:
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REPRESENTANTE OFICIAL JUNTO À PLASTIVIDA
NOME:
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CARGO:
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TEL.:
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E-MAIL:
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DADOS PARA COBRANÇA
ENDEREÇO COMPLETO: (se diferente do informado acima)
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NOME DO RESPONSÁVEL:
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E-MAIL:
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