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ENTRY FORM

500 Km Motorland

COMPETITOR

DRIVER 1

DRIVER 2

DRIVER 3

DRIVER 4

VEHICLE

BILLING INFORMATION

Registration fees amount 940,00€ +21% IVA/VAT/TVA = 1137,40€ ( private practice included ) 1880,00 +21% IVA/VAT/TVA = 2274,48€ (without mandatory publicity) (private practice included ) CAIXABANK 2100-0499-71-0200135857 IBAN ES41 2100 0499 7102 0013 5857 SWIFT: CAIXESBBXXX Registration must be completed and submitted, along with payment voucher to V-Line Org ( e-mail montse@vlineorg.com) deadline is fixed to 17 November, 2017 at 18:00

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