Please print this form, fill it out and fax or mail to:

 

 
Nada Waldhör
Bichlmairstr. 3

D-83703 Gmund am Tegernsee
Deutschland

 
Faxnummer Deutschland:
 0049-(0)8022-664 98 51

Telefon Deutschland:
0049-(0)8022-664 98 50

Ayurveda Italy
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Deposit: 250 Euro at:
Kreissparkasse Gmund (Germany):
BLZ 711 525 70		 Bank Account: 8591760
BIC code: BYLADEM1MIB
IBAN: DE27 7115 2570 0008 5917 60
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Date: Signature:
 
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