including transfer fees. Bank: Banca Prossima (Intesa San Paolo) IT 46 E 03359 01600 100000 100118 International Bank Account Number IBAN: BCITITMX Business Identifier Code BIC: Account Name: ASD L’aquilone Reference: L’Aquila Goalball Tournament Payment Summary: 25 % 75 % deposit deposit payable paid € 270,00 per person for 3 nights arriving to lunch € € on 11 October to breakfast on 14 October 2018 This form must be returned by E-Mail no later than 10 September 2018 to: Form 4 Arrival / Departure Details – by 10 September 2018 Country: Arrival details: N° of Date Time Flight No. persons Departure Arrival from Airport
including transfer fees. Bank: Banca Prossima (Intesa San Paolo) International Bank Account Number IBAN: IT 46 E 03359 01600 100000 100118 Business Identifier Code BIC: BCITITMX Account Name: ASD L’aquilone Reference: L’Aquila Goalball Tournament Payment Summary: 25 % deposit paid 75 % deposit payable € 270,00 per person for 3 nights arriving to lunch on 11 October to breakfast on 14 October 2018 € € This form must be returned by E-Mail no later than 10 September 2018 to: Form 4 Arrival / Departure Details – by 10 September 2018 Country: Arrival details: Date Time Flight No. N° of persons Departure from Arrival Airport