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First name:

Last name:

Address:

Postal code / Town or city:

Country:

Phone:

E-mail:

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1. Upload logo:

(bmp, gif, jpg, png, tif - 150 x 75 pixels recommended)

2. Enter URL:

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3. Slogan or advertising text:

(100 characters left)

4. Sponsor prizes:

Cash Material prize or voucher:

(description only in english or german please)

5. State value in Euros:

€

(min. € 10,00)

Invoiced amount:

Voucher Code:

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