Layout Block - Block Reference - Make a Wish

My gift (value max. 1.000 EUR): *

To*: *

Why I think this person deserves this gift: *

From: *

My phone number *

My e-mail address *

I am a Raiffeisen member: *

Yes

No

I have read and accept the terms and conditions of the contest.

I certify that the person named above and I will be available from December 13th to 20th, 2018 to receive the gift.

*The designated person has to have reached the age of majority and has to be resident of the Grand-Duchy of Luxembourg.