JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Afro-Brazilian Masterclass in London
www.irineunogueira.com
* Indicates required question
Email
*
Your email
Full Name:
*
Your answer
Mobile Phone:
*
Your answer
CONTRIBUTION:
£
35 with this registration and transfer (at the door
£
40)
I understand that once I submit this form I will be bound to pay the above fee until March 22.
*
Yes
Required
PAY WITH PAYPAL
Please pay via PayPal through
www.paypal.me/irineunogueira
selecting the '
Friends&Family
' payment option,
so that no transaction fees apply.
PAY VIA UK BANK TRANSFER
Account holder: José Irineu Nogueira Junior
Sort code: 23-14-70
Account number: 96268148
IBAN: GB32 TRWI 2314 7096 2681 48
Please send the proof of payment to
contact@irineunogueira.com
Thank you!
Comments/Remarks:
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
