[av_textblock size=” font_color=” color=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” av_uid=’av-jpfapn4s’ admin_preview_bg=”] Filling the form here below before doing a liberal dispensing, you will let us know who you are and we’ll send you the required receipt according to law.

Then press GO and you will be redirected to the detailed page for liberal dispensing.
[/av_textblock] [av_hr class=’default’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-thin’ custom_width=’50px’ custom_border_color=” custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’yes’ custom_icon_color=” icon=’ue808′ av-desktop-hide=” av-medium-hide=” av-small-hide=” av-mini-hide=” av_uid=’av-b2npg’] [av_contact email=’donazioni@assocecilia.org’ title=’Donations contact’ button=’GO’ on_send=’redirect’ sent=’Your message has been sent!’ link=’manually,http://www.assocecilia.org/en/donate-2/’ subject=’donation’ autorespond=’Thanks! When we’ll receive the liberal dispensing, we’ll send you a receipt to the indicated email address’ captcha=” form_align=” color=” av_uid=’av-jpfaw2mh’ admin_preview_bg=”] [av_contact_field label=’Name’ type=’text’ check=’is_empty’ options=” multi_select=” av_contact_preselect=” width=” av_uid=’av-14wk78′][/av_contact_field] [av_contact_field label=’Last Name’ type=’text’ options=” check=’is_empty’ width=” av_uid=’av-ycffg’ multi_select=” av_contact_preselect=”][/av_contact_field] [av_contact_field label=’Address’ type=’text’ options=” check=’is_empty’ width=” av_uid=’av-q8bzw’][/av_contact_field] [av_contact_field label=’Postal Code’ type=’text’ options=” check=’is_number’ width=” av_uid=’av-mi14c’][/av_contact_field] [av_contact_field label=’City’ type=’text’ options=” check=’is_empty’ width=” av_uid=’av-fcldg’][/av_contact_field] [av_contact_field label=’Country’ type=’text’ options=” check=’is_empty’ width=” av_uid=’av-7g338′][/av_contact_field] [av_contact_field label=’Fiscal Code’ type=’text’ options=” check=’is_empty’ width=” av_uid=’av-tfk58′ multi_select=” av_contact_preselect=”][/av_contact_field] [av_contact_field label=’E-Mail’ type=’text’ check=’is_email’ options=” multi_select=” av_contact_preselect=” width=” av_uid=’av-mgcxo’][/av_contact_field] [av_contact_field label=’Donation extent’ type=’text’ options=” check=’is_number’ width=” av_uid=’av-hb03g’ multi_select=” av_contact_preselect=”][/av_contact_field] [av_contact_field label=’Message’ type=’textarea’ options=” check=” width=” av_uid=’av-bl3ac’ multi_select=” av_contact_preselect=”][/av_contact_field] [av_contact_field label=’I approve privacy conditions (see below)’ type=’checkbox’ options=” check=’is_empty’ width=” av_uid=’av-77g4s’ multi_select=” av_contact_preselect=”][/av_contact_field] [/av_contact] [av_textblock size=” font_color=” color=” av-medium-font-size=” av-small-font-size=” av-mini-font-size=” av_uid=’av-jpkd3ksv’ admin_preview_bg=”] * mandatory field
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