Registration Form

Subscription form for corporate

Your Order:

Payment for subscription
corporate

Total: € 8.000,00

Please note:

Registration is valid from January to December (calendar year), regardless of when the fee is paid. For those who register between November and December, the subscription will be valid for the last months of the current year and for the following one.

The time taken to receive the card is about 10 days.

For any info and questions

Tel +39 02 860796
Fax + 39 02 867354
info@amicidibrera.org

Subscription data*
First Last
Email*
Phone
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Place of Birth*
Are you a company?
- Yes
- No
Company name
Tax code | VAT Number*
Subscription Type
In addition to the subscription fee, I want to donate
Total
0,00 €
DESIDERO PAGARE CON:
Credit Card

Discover
MasterCard
Visa
Maestro
Supported Credit Cards: Discover, MasterCard, Visa, Maestro
Card Number Expiration Date Security Code Name on card
- Payment in cash at our headquarters in via Brera 28
- Payment by bank transfer to bank account no. 4542 at Banca Popolare di Milano IBAN: IT56L05034017310000004542
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