PRE-ASOCIACION FORM FOR INTERNATIONAL PARTNERS

 

The shipment of this form does not imply the association to the Club, since first the requirements must be fulfilled previously mentioned to comprise of this Organization, which will be verified by the Organizing Commission.

 

PERSONAL DATA

 

 FIRST NAMES: LAST NAMES:

 

 

 SEX:  MALE FEMALE   BIRTHDAY:   

 

 

 DOCUMENT Type:   Number:    BLOOD GROUP Group:   Factor:

 

 

 ADDRESS:   Street: Number:   Floor:   Apartament:

 

 

 City:   Province/Estate:

 

 

 Country:  ZIP / Postal Code:

 

 

TELEPHONE:  Country Code: () Locate Code: () Number:

 

 

MOBILE PHONE: Country Code () Locate Code: () Number:

 

 

 E-MAIL:

 

 

VEHICLE DATA

 

 MODEL:

 

 TIPO:

 

Sedán 2 puertas

Sedán 4 puertas

Coupé 2 puertas

Rural 2 puertas

Rural 4 puertas

Pick Up

 

 

 COLOR:   YEAR:   LICENSE:

 

 

ADITIONAL INFORMATION / COMMENTS: