DROME magazine

info: www.dromemagazine.com – [email protected]
Subscription to DROME magazine
SPECIAL GIFT OFFER
VALID UNTIL 13.01.2013
- 4 issues:
¤ € 30,00 (Italy)
¤ € 40,00 (International)
- 8 issues:
¤ € 50,00 (Italy)
¤ € 75,00 (International)
- Supporter Subscription (for life):
¤ € 250,00
* For renewals, cultural/educational institutions (libraries, museums, schools etc.) and students:
Italy ¤ € 26,00 (4 issues) ¤ € 49,00 (8 issues)
International ¤ € 37,00 (4 issues) ¤ € 74,00 (8 issues)
Name and Surname / Organization _______________________________________________________________
Address
Street________________________________________________________________ City___________________
Zip Code _______________________ Country _______________________ Tel. __________________________
Mobile ______________________ E-mail _________________________________________________________
VAT Nr _____________________________________________________________________________________
Date ___________________ Signature ____________________________________________________________
PLEASE SEND YOUR PAYMENT IN ADVANCE FOR THE SUBSCRIPTION TO BEGIN.
WHAT TO DO:
Please fill out the form and send it via e-mail ([email protected]) or via post to: Associazione
Culturale PHLEGMATICS - Via delle Officine, 15 - 98040 Venetico Marina (ME), Italy, with proof of payment.
Bank transfers payable to:
Associazione Culturale PHLEGMATICS - Banca Popolare ETICA s.c.a.r.l.
EUR IBAN: IT52 X050 1803 2000 0000 0112 668 Cod. BIC: CCRTIT2T84A
The subscription will start with the upcoming issue (following the date shown on your proof of payment).
IF YOU HAVE ARRANGED YOUR SUBSCRIPTION DIRECTLY WITH OUR OFFICE, THIS FORM WILL ACT AS A RECEIPT ONCE
PRINTED, COMPLETED, STAMPED AND SIGNED BY THE RECIPIENT.
Garanzia di riservatezza degli abbonati (legge D.L. 196/03 – tutela dei dati personali)