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Formulari WEB PARADES SANT JORDI 2023
Dades per demanar la parada davant de la floristeria a través del programa DRAC
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* Indicates required question
Nom de la FLORISTERIA
*
Your answer
Adreça de la floristeria (carrer i número)
*
Your answer
Codi Postal
*
Your answer
Dades del titular del CERTIFICAT DIGITAL (nom i cognoms)
*
Your answer
Dni/Nif del titular del CERTIFICAT DIGITAL
*
Your answer
Telèfon de contacte
*
Your answer
E-mail de contacte
*
Your answer
Voldreu una segona parada en el radi d'influència de la vostra floristeria?
*
SI
No
En cas de SI escriu l'adreça (carrer i número)
*
Your answer
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