Online-shop // Piaf card

Piaf card € 60

Please complete the form below and we shall notify you when you may collect the card from the shop. 

Apply here for your Piaf card

City*	Mechelen
Product *	Piaf card
Name *
Surname *
E-mail *
Telephone *
Address *
House number *
Postal code *
City *
Vehicle Registration Number 1 *
Vehicle Registration Number 2
Extra message
Copy of identity card **
Vehicle´s registration certificate **
Certificate from the leasing company or owner **
Other **

* Mandatory fields // ** Word file or Pdf