Ansökan om medlemskap i Prima Gruppen Namn:____________________________________________ Personnummer:_____________________________________ Adress:____________________________________________ __________________________________________________ E-post:____________________________________________ Telefon:___________________________________________ Eventuella referenser:________________________________ __________________________________________________ Datum och underskrift:_______________________________ För Prima Gruppen Godkänt Avslag p.g.a._________________________________ Datum:__________________________ Signatur:________________________ Prima Gruppen 802011-5146 www.primagruppen.se info@primagruppen.se Krinolinen HVB Fredrika Bremers gata 33 129 50 Hägersten tlf: 08-464 94 50 fax: 08-464 92 60 Roo Gård Lantbrukskooperativ 184 93 Åkersberga tlf: 08-543 533 50 fax: 08-543 533 53
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