TEC

Your contact details

This contact information must match the person concerned.

How is my data used?

Last name *

First name *

Title *

E-mail address *

Confirm e-mail address *

Street

Number

PO box

Postcode

Locality

Description

Region *

Trip

From (address or stop) *

Destination (address or stop) *

Period

Month *

Year *

Price

Birthdate *

Transport document

Are you a subscriber? Yes No

To receive your certificate, please pay the sum of €5 to the account of the Walloon Brabant Direction : BE51 0013 8658 2462 (BIC : GEBABEBB) with the following structured message: price certificate + surname + first name

To receive your certificate, please pay the sum of €5 to the account of the Charleroi Direction : BE79 0910 0073 7633 (BIC : GEBABEBB) with the following structured message: price certificate + surname + first name

To receive your certificate, please pay the sum of €5 to the account of the Hainaut Direction : BE45 0910 2156 9189 (BIC: GKCCBEBB) with the following structured message: price certificate + surname + first name

To receive your certificate, please pay the sum of €5 to the account of the Liège-Verviers Direction : BE54 0910 0078 2897 (BIC : GKCCBEBB) with the following structured message: price certificate + surname + first name

To receive your certificate, please pay the sum of €5 to the account of the Namur-Luxembourg Direction : BE96 0960 1173 5405 (BIC : GKCCBEBB) with the following structured message: price certificate + surname + first name

Requesting a price certificate

Your contact details

Description

Trip

Period

Price