Isibonelo sefomu lokukhansela · United Kingdom

(Gcwalisa futhi ubuyisele leli fomu kuphela uma ufuna ukuhoxa esivumelwaneni.)

Umamukeli: José Luís Santos Monteiro — Montarion Universe, Rua Sousa Pinto, 199, 1.º E, 4250-481 Porto, Portugal; montarionuniverse@gmail.com.

Mina/Thina (*) ngiyakwazisa/siyakwazisa ukuthi mina/thina (*) ngiyakhansela/siyakhansela isivumelwano sami/sethu (*) sokuthengiswa kwalezi zimpahla ezilandelayo (*)/sokuhlinzekwa kwale nsizakalo elandelayo (*):

Izimpahla / izinsizakaloYa-odwa ngomhla ka (*) / yamukelwa ngomhla ka (*)Igama lomthengi/labathengiIkheli lomthengi/labathengiIsiginesha yomthengi/yabathengi (kuphela uma ifomu lithunyelwa ephepheni)Usuku

(*) Dweba umugqa kulokho okungasebenzi.

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