World Wide Absentee Registration

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selected Number, class

Registrant Name *

Vorname

Nachname

Registrant Email *

Phone

Registrant Adress (Street, Number, Zip Code, City) *

Participant Name *

Vorname

Nachname

Location of the selected class *

Date of the selected class *

Message

Payment via

• PayPal or Credit Card – 220,00 €

PayPal Commerce *

PayPal CheckoutCredit Card

Card Number

Expiration Date

Security Code

Card Holder Name

Send Form

Please transfer the amount of 220 euros to:

PayPal – office@hooponoponogermany.de

or

Muenchner Bank I Irene Schwonek | BAN – DE64 7019 0000 000 2442914 | Genodef 1M01