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NSX & HONDA Sportcars Club

c/o Jean C. Zucker
Route du Gd-St-Bernard 36
CH 1933 SEMBRANCHER
Switzerland
Phone +41 (0)79 2103060
Fax +41(0)27 7851505
info@nsx.ch
www.nsx.ch


- Mugello (I) -

Tuesday June 6th, 2017

Form to be completed before MAY 15th, 2017.
Do not forget the bank transfer.

* Required fields

* Name
 
 
* Surname
 
 
* Street
 
 
* City / Postcode
 
 
* Country
 
 
* Phone
 
 
Fax
 
 
* Email
 
 
* Car
 
 
Club
 
 

 
I will be driving on 6th June 2017 [EUROS 850.00]
EUROS
850.00

 
 
TOTAL
EUROS
850.00


TOTAL
 
EUROS 850
 
 
I am paying this sum by credit transfer to the account of the
NAME NSX & HONDA SPOTCARS CLUB
BANK CREDIT SUISSE, 1920 MARTIGNY (CH)
IBAN CH9104835066694282000
BIC/SWIFT CRESCHZZ80A
ACCOUNT N° 666942-82
MONNEY EUROS (€)

Checks are not accepted.

Your forward security code is 9RV3YBFZH

* Security code