Enrollment Declaration
| First name:* |  |
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| Surname:* | |
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| Date of Birth:* | |
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| Street and number:* | |
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| Postal code:* | |
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| City:* | |
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| Country:* | |
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| Landline: | |
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| Mobile: | |
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| E-Mail:* | |
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| Fax: | |
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| Annual Contribution:* | |
30 EUR for Students 60 EUR for regular Members 90 EUR for sustaining Members 120 EUR for child Sponsors |
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*) mandatory information
