ࡱ> 9 bjbj.Ll& D &< 6|6@       $ /^0]vvv0JJJJv^ Jv JJ p;¦& 0vJ&& ITALIA vs FRANCIA Sabato 5 Giugno 2010 ore 18,00 PalaPanini Modena MODULO PER ACQUISTO BIGLIETTI Da inviare a C.P. FIPAV di MODENA Esclusivamente a mezzo mail - indirizzo:  HYPERLINK "mailto:info@fipav.mo.it" info@fipav.mo.it Sig. FORMTEXT       FORMTEXT      Cognome e NomeSociet Richiedente  FORMTEXT       Denominazione Societ - Localit - Affiliata al C.P. FIPAV CODICEPersona di riferimento Societ  Sig: FORMTEXT       Cognome e NomeTel. / Cell FORMTEXT      Email FORMTEXT      RICHIEDEn. FORMTEXT     Biglietto/i INTERO TribunaPrezzo unitario: 20,00 euron. FORMTEXT     Biglietto/i INTERO Gradinate Prezzo unitario: 12,00 Euron. FORMTEXT     Biglietto/i RIDOTTO Gradinate (*)Prezzo unitario: 8,00 Euro(*)Per i minori di anni 18 e per TUTTI i TESSERATI FIPAV Importo Totale FORMTEXT      PROMOZIONE C.P. >> per ogni squadra che acquister i biglietti (12) l accompagnatore entra GRATISsi allega copia del versamento eseguito su: (barrare il metodo prescelto)Ccp 11769411 FORMTEXT   IBAN: IT95Q0518812903000000023494 FORMTEXT   IBAN: IT73P0538712921000001441450 FORMTEXT  RITIRO BIGLIETTIPresso BIGLIETTERIA ACCREDITI il giorno della gara  FORMTEXT  Presso C.P. FIPAV Modena entro le ore 18 del giorno 01/06/2010  FORMTEXT   UNITAMENTE ALL INVIO DEL PRESENTE MODULO DOVRA ESSERE TRASMESSA VIA E-MAIL ( HYPERLINK "mailto:info@fipav.mo.it" info@fipav.mo.it) COPIA DELLA RICEVUTA DI VERSAMENTO IL PRESENTE MODULO POTRA ESSERE CONSEGNATO PER GLI ACQUISTI IN CONTANTI DIRETTAMENTE ALLA SEGRETERIA C.P. 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