reservation form - European Championships For Arabian Horses 2014

RESERVATION FORM
I, the undersigned M ……………………………………………………………………………………………………………………………
Wish to sponsor the European Championships for Arabian Horses 2014, 25th & 26th October, at the ‘Zilveren Spoor’,
Overheulestraat 235, 8560 Moorsele, Belgium
According the Sponsorship type :………………………………………………………………………………………………………..
For an amount of : …………………………………….. EUROS
This participation will be announced in the program as sponsored by:
Company/Stud Name: …………………………………………………………………………………………………
Address: ………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………….
Post Code: …………………. City: ………………………………… Country:……………………………………
Phone: …………………………………………………… Fax: ………………………………………………………….
Email: ………………………………………………………………………………………………………………………….
The amount of the sponsorship must be paid no later than the closing date of entries,
It is to say October, 3th 2014
Payment conditions:
-
By check at the order of:
vzw ECPAH, Berkensingel 24, B-2490 BALEN, Belgium
-
By bank transfer, Bank references
BNP FORTIS PARIBAS
Agency: Markt 11 B-2490 BALEN
Account: 230-0139487-21
IBAN BE 17230013948721
BIC GEBABEBB
Name : ………………………………………………………….
Date: …………………………………………………………….
Signature & Stamp ……………………………………….
ORGANIZATION : ECPAH vzw
Christine Jamar-Demeersseman
Berkensingel 24
B-2490 Balen-Belgium
Tel. 0032 (0) 14 81 24 62
Fax 00 32 (0) 14 81 24 22
ECPAH
vzw
email: [email protected]
Payment: Fortis Bank : 230-0139487-21 • Markt 11, B-2490 Balen - Belgium
IBAN : BE 17 2300 1394 8721 • SWIFT(BIC) : GEBABEBB

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