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ESN Cards (ESN CÓRDOBA) 23/24
You are registering a ESNcard for the section ESN Córdoba, at a cost of
12,00€.
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Email
*
Your email
Name
*
Your answer
Surname
*
Your answer
Gender
*
Female
Male
Other:
Full number (Including prefix)
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Adress
Your answer
Country
*
Your answer
ID/ Passport
*
Your answer
Date of Issue (ID/Passport)
*
MM
/
DD
/
YYYY
Payment Method (12€)
*
Cash at the office
Card at the office
Bank transfer: ES34 0049 4277 8628 1413 1166 (Indicate full name + ESN CARD)
AUTORIZACIÓN PARA GRABACIÓN Y USO DE CONTENIDO AUDIOVISUAL
Puede consultar la información del tratamiento de su imagen por la asociación sin ánimo de lucro
Erasmus Student Network Córdoba
en el siguiente
enlace
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