MEMBERSHIP FORM

I, THE UNDERSIGNED :
ADDRESS :
POSTCODE :
TOWN :
COUNTRY :
TELEPHONE : EMAIL :
Agree to be updated on the news of the association only by email.

I wish to join the association,  LES AMIS DE VAUX LE VICOMTE.

As a member
PICK YOUR CHOICE Single (45 €) [comes down to 15.30€ after tax deduction if applicable] Couple (45€) [comes down to 20.40€ after tax deduction if applicable] Family (90 €) [comes down to 30.60€ after tax deduction if applicable] Junior member (<26 years) [comes down to 10.20€ after tax deduction if applicable] Donor (150 €)[comes down to 51 € after tax deduction if applicable] Benefactor (550 €)[comes down to 187 € after tax deduction if applicable] and enclose with this form the sum of euros in settlement.

Please fill the second card with:

NAME :
ADDRESS :
POSTCODE :
TOWN :
TELEPHONE : EMAIL :
Agree to be updated on the news of the association only by email.

Settlement : PICK YOUR CHOICE Cheque (French banks only) Cash

The information obtained is required for your membership. It is processed by computer and meant for the staff of the Association. In conformity with article 34 of the Act of 6 January 1978, you have a right of access to and emendation of the information that concerns you.