[
(#COURRIEL)
] [
(#TITRE)
] [
(#MONTANT) €
]
[
(#NOM)
] [
(#PRENOM)
] [
(#CODE_POSTAL)
] [
(#ADRESSE)
] [
(#VILLE)
] [
(#RECU_FISCAL|?{"oui","non"})
] [
(#ENVOYER_INFO|?{"oui","non"})
] [
(#INFORMER_COMITE_LOCAL|?{"oui","non"})
]