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Internet TV Fixed telephony Mobile My bill My subscription MyScarlet Order assistance Legal guardianship Other Reason for contact: (optional) {{errorMessages.reasonforcontact.required}} {{errorMessages.reasonforcontact.pattern}}

M F X Gender: (optional) {{errorMessages.gender.required}} {{errorMessages.gender.pattern}}

Customer no.* {{errorMessages.CusI.required}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI}} {{errorMessages.CusI.pattern}}

Name*: {{errorMessages.LastName.required}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName}} {{errorMessages.LastName.pattern}}

First name*: {{errorMessages.FirstName.required}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName}} {{errorMessages.FirstName.pattern}}

E-mail*: {{errorMessages.MAILBACKADDR.required}} {{errorMessages.MAILBACKADDR.pattern}} Please match the e-mail address above {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR}} {{errorMessages.MAILBACKADDR.pattern}}

Phone no.: (optional) {{errorMessages.CALLBACKCLI.required}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI}} {{errorMessages.CALLBACKCLI.pattern}}

Street: (optional) {{errorMessages.street.required}} {{errorMessages.street.pattern}} {{errorMessages.street.pattern}} {{errorMessages.street.pattern}} {{errorMessages.street}} {{errorMessages.street.pattern}}

No.: (optional) {{errorMessages.no.required}} {{errorMessages.no.pattern}} {{errorMessages.no.pattern}} {{errorMessages.no.pattern}} {{errorMessages.no}} {{errorMessages.no.pattern}}

Box: (optional) {{errorMessages.box.required}} {{errorMessages.box.pattern}} {{errorMessages.box.pattern}} {{errorMessages.box.pattern}} {{errorMessages.box}} {{errorMessages.box.pattern}}

Postal code: (optional) {{errorMessages.PostalCode.required}} {{errorMessages.PostalCode.pattern}} {{errorMessages.PostalCode.pattern}} {{errorMessages.PostalCode.pattern}} {{errorMessages.PostalCode}} {{errorMessages.PostalCode.pattern}}

City: (optional) {{errorMessages.commune.required}} {{errorMessages.commune.pattern}} {{errorMessages.commune.pattern}} {{errorMessages.commune.pattern}} {{errorMessages.commune}} {{errorMessages.commune.pattern}}

Enquiry*: {{errorMessages.questions.required}} {{errorMessages.questions.pattern}}