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Fer-se soci
Per fer-se soci del Motor Club La Canonja cal omplir aquest formulari.
La quota és de 15€/any. El cobrament es fa a primers de febrer.
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NOM
*
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Cognoms
*
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DNI
Amb lletra
Your answer
Telèfon mòbil
*
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Adreça
*
Carrer o Av. o Plaça ... Número. Pis. Porta.
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Codi Postal
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Població
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Número de compte del Banc o Caixa on vols que et fem el cobrament en format IBAN
*
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BIC del Banc.
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Correu elèctrònic
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Ets menor de 16 anys?
si
no
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Si ets menor de16 anys, indica la data de neixament
MM
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DD
/
YYYY
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