ADHESION_formulaire_vierge

01Member

First name

Last name

Date of birth

Phone

E-mail

02Address

Street

Postal code / City

03Membership type

Discovery member– free Contributing member– 50 CHF / year Honorary member

04Membership fee

Payment method Bank transferCash

AmountCHF

IBAN CH75 0900 0000 1479 0391 1 Bank PostFinance Account holder ACKG (Association Culturelle Kurde de Genève

05Declaration

I wish to become a member of the association and undertake to respect its statutes and values. The information provided is accurate.

Place and date

Member's signature

06For office use

Approved Pending Rejected

Fee received on

Due date

Initials

Return this form to the association or send it by e-mail to info@ackg.ch
For paid memberships, membership is confirmed upon receipt of the fee.