By completing and sending us this form you confirm that you would like to endorse the I Madonnari documentary project, by (pre)ordering the DVD-download (expected release early 2013) and for the amount of EUR. 25,-.
write your first name here
Your Last Name
write your last name here
write your email here
Your Phone Number (incl. country acces code)
write your phone number here
How would you like to pre-order and make your pre-payment?
you can select more options
via the paypal Facebook App - FundRazr (you do not need to have a paypal account or a facebook page)
via regular (international) bank transfer
via Ideal (this option is for the netherlands only)
In case you checked 'Other', please explain here
explain here how you would like to support us
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service