Order form Coffee breaks | Vrije Universiteit Brussel

Applicant type

Internal applicant

External applicant

Address

Address 2

City

State/province/region

Postal code

Country

BTW number

Service

Contact

First name

Last name

E-mail

Phone number

Invoice reference

PKC

Delivery or pick up

Delivery

Pick up

Room number (if delivered)

Pick up date

Pick up time

Start hour activity

End hour activity

Number of people COFFEE/TEA

Number of bottles of STILL WATER 1L

Number of bottles SPARKLING WATER 1L

Number of bottles of FRUIT JUICE 1L

Number of bottles of COLA 0,5L

Amount of bottles of COLA ZERO 0,5L

Number of MINI PASTRIES

Other DESSERTS

Amount

Other DESSERTS

Amount

Other DESSERTS

Amount

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