Registration form

Por favor llena los espacios en blanco con los datos que se te solicitan

Commercial and advertising information

Tax information of the company

Contact person

Solidarity option

Indicate the number, name and percentage of donation of the solidarity dishes

I have read and I accept the terms and conditions of the Agreement for the participation of A Dish with Impact

Thank you for confirming you subscription to the campaign A Dish with Impact! We will be confirming your subscription via email.

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Privada de Magnolias #109, Col. Reforma, C.P. 68050 Oaxaca, Oax