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I hereby transfer the amount of EUR 100.- to Wydawnictwo Jacek Romanowski, Sienna 43/15, 00-121 Warszawa, Poland,
VAT No: PL 5251049621
BANK Ochrony Srodowiska III O/Warszawa, Swift Code (BIC):
EBOSPLW 287, Account No: 06 1540 1287 2001 6875 7454 0001
I agree that Wydawnictwo Jacek Romanowski can store and use the above data for promotion purposes. I have the right to see the data and update them any time.
Date and Signature
After the Form is carefully filled please print and send it by post to Wydawnictwo Jacek Romanowski, P.O.Box 1018, 00-950 Warszawa 1, Poland.
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