Form

GENERALITA'

Surname and name (requested)

Address

Zip Code

City

Provincia

Date of Birth

Place of birth

As the legal representative of the company / Association

Based in

References

Adhesion independent
 Yes No

Adhesion for referral of

PHONE NUMBERS

Office Telephone

Cellular Phone

Email Address (requested)

I ask you to join the Association "NEXT SICILY INFORM@" and declare to know and accept in full the laws in force.

The membership fee is € 10.00 per ordinary members and € 80.00 for the associations to be paid once a year. The cost to have a page in the portal Next Sicily Inform@ is € 200.00 one-off. The annual cost of maintenance is € 80,00.

I authorize the processing of personal data aimed at the management of membership, in accordance with Decree 196/03.

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