Your name

Your surname

Your email

Town you nominate

Size
how many habitants?< 5.000 people5.000 - 10.00010.000 - 40.000>40.000

Country

Has Co-Working
selectYes, of course!No, unluckly!

Has Fast-Connection (optical fiber)
selectYes, of course!No, unluckly!

Do you think you have what it takes to be the next Town Angel? Tell us why!