MEMBERSHIP PRINT

Yes, I want the club FBiG eV assist its work, and therefore register as a member. I get documents sent as soon as my annual membership to the association's account is credited.

Member

Sustaining Member

Professional?

in Education?

First name:
Name:
Date of Birth:
Street:
Postal Code:
City:
Country:
Occupation:
Phone:
e-mail:
HomePage (if any):
Membership per year: 60 €
I will pay my membership fees by bank transfer to the account of the association.
I hereby authorize the Association FBiG eV to debit to withdraw my membership and my registration fee of € 8.00 from my account:
Bank:
Sort code:
Account no.:
Datum:	23.01.2011 01:56	Ort:
Unterschrift:______________________________________
Please sign!
FBiG e.V. z.Hd. J. Wilkens, Höhenweg 6, D-91522 Ansbach Tel.: +49 (0)981 2141172 Fax: +49 (0)981 2174577

The application we are effectively, if your annual contribution to the association's account is credited and you do not cancel your membership within 14 days. If you wish to waive your right of cancellation, please indicate this in the message box.