City Kiosk : Request for Offer
  1. Thank you for your interest! If you agree with our terms and conditions, please complete this document.
  2. Choose between:*
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  3. Family name*
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  4. First name*
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  5. Gender*
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  6. Date of birth*
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  7. Email
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  8. Mobile phone number*
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  9. Nationality EU*
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  10. Nationality non EU
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  11. Address*
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  12. Current position*
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  13. Where do you know City Connexion from ?
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  14. Company data for further review:
  15. Company name*
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  16. Contact person*
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  17. Position*
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  18. Company's address*
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  19. Email
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  20. Telephone*
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  21. VAT number*
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  22. Website*
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  23. In which language would you like the activity (or advice):*
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  24. Requested service*
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  25. Some city facilitators have notions of Spanish or German . Please mention as it might be helpful to you.
  26. Comments and clarification
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  28. *

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