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CMN - EMPRUNT AUPRES DES ADHERENTS
Questionnaire pour souscription pour le financement de l'achat d'AVEL TEZ -
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Nom et Prénom
*
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Adresse postale
*
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Portable et mail
*
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Votre statut
*
Adhérent
Sympathisant
Required
Si sympathisant, de quel adhérent:
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Montant de votre souscription
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250 €
500 €
750 €
1000 €
> 1000 € => voir question suivante
Précisez votre montant de souscription si supérieur à 1000 €
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