[Var: "txt_registration_title"; Sprache: "F"]

Dates personnel

[Var: "txt_registration_customertype"; Sprache: "F"]* --choisir s.v.p.-- [Var: "txt_company"; Sprache: "F"](*) Prénom (*) [Var: "r_nachname"; Sprache: "F"](*) Adresse* NPA * [Var: "txt_field_city"; Sprache: "F"]* Pays * --choisir s.v.p.-- Suisse Allemagne Autriche Bulgarie Tél.* E-Mail*

[Var: "txt_bank_information"; Sprache: "F"]

F_bank_acc_user(*) F_bank_acc_iban(*) F_bank_name(*) F_bank_address_zip(*) F_bank_address_city(*) F_bank_country(*)