forms

Title*

1. Mr
2. Mrs
3. Miss/Ms

Family name*

First name*

Email*

Telephone*

Fax

Street, number, PO box if applicable*

Postal code*

Place

Country

You are contacting us as:*

1. Regular customer (with MOBIB card)
2. Occasional customer (without MOBIB card)
3. I am interested / futur customer / visitor
4. Third party (road user, professional, etc)
5. Local resident (projects, works, nuisance, etc)

Remember my data on this computer for a next visit

Law of December 8, 1992 - In order to manage your your message or file and to respond to your questions or remarks, STIB collects the above personal data regarding you. You can, on simple written request and on production of your identity card, have access to this data, obtain the modification of this data, and oppose yourself free of charge against further use of your data. This data is only used by STIB. The responsible party for handling your data is STIB, rue Royale 76 in 1000 Brussels.