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brochure Week van de Smaak 2007 - FOV

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. Gegevens <strong>van</strong> <strong>de</strong> organisator (verplicht)*:<br />

Naam organisatie: ............................................................................................ (verplicht)<br />

.............................................................................................................................................<br />

Straat/nummer/bus: ....................................................................................... (verplicht)<br />

.............................................................................................................................................<br />

Postco<strong>de</strong>/gemeente: ........................................................................................ (verplicht)<br />

.............................................................................................................................................<br />

Telefoon/gsm: .................................................................................................. (verplicht)<br />

E-mail: ............................................................................................................ (verplicht)<br />

Website organisatie: ..........................................................................................................<br />

Geef een contactpersoon op voor <strong>de</strong> <strong>Week</strong> <strong>van</strong> <strong>de</strong> <strong>Smaak</strong>:<br />

Naam: ............................................................................................................... (verplicht)<br />

Telefoon/gsm (direct): .................................................................................... (verplicht)<br />

E-mail (persoonlijk): ...................................................................................... (verplicht)<br />

.............................................................................................................................................<br />

Administratieve gegevens v/d organisator:<br />

De organisatie is een: ❍ profitorganisatie ❍ non-profitorganisatie<br />

Geef hier het facturatieadres <strong>van</strong> <strong>de</strong> organisatie, indien verschillend <strong>van</strong> adres<br />

hierboven:<br />

Naam: .................................................................................................................................<br />

Straat/Nummer/Bus: ........................................................................................................<br />

.............................................................................................................................................<br />

Postco<strong>de</strong>/Gemeente: .........................................................................................................<br />

.............................................................................................................................................<br />

4

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