Surname : Forename : Zip code, place : Country : E-Mail : Telephone : Handy : Yes, I want a portrait of mine at the cost of 300,- € My photograph : Pelease upload a jpg file with a size less than 5 MB. Watch out not to use wide spaces and special characters. I will transfer the 300 € to... Kreditinstitut: Kreissparkasse Wesermünde-Hadeln Bankleitzahl: 292 501 50 Kontonummer: 14700 1099 I would like to pay in 3 monthly bills by 100,- € I allow Mr. Krueger to use my portrait in an upcoming exhibition... ...by mentioning my name. ...without mentioning my name. Additional note :
