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Membership Form

PLEASE PRINT OUT THE FOLLOWING FORM, COMPLETE IT IN FULL AND POST IT WITH YOUR SUBSCRIPTION FEE TO:

Charente-Limousine Exchange, 2 Rue St Michel, Confolens, 16500. France

MEMBERSHIP FORM

Please write clearly and use capitals throughout

FAMILY NAME

 

FIRST NAME(S)

 

ADDRESS

 

   

TELEPHONE

 

E-MAIL

 

NO IN HOUSEHOLD

 

AGES OF ANY CHILDREN

 

           

Please give brief details of your interest, skills or knowledge, current or former profession (If you run your own registered business see separate section). For a couple please each give details - continue on reverse if necessary::

 

 

   

 

If you have a registered business in France, please details below:

NOTE: We cannot include details of your business if it is not registered, although you may indicate if you are currently going through the registration process:

NAME OF BUSINESS

 

NATURE OF BUSINESS

 

SIRET NUMBER

 

  WE PRODUCE A MEMBERSHIP LIST AVAILABLE ON REQUEST.  DO YOU WANT YOUR DETAILS TO BE ADDED TO THIS LIST?

 

YES:             NO: 

 MEMBERSHIP IS ONLY 15 EUROS* PER FAMILY PER CALENDAR YEAR AND IS PAYABLE BY CHEQUE TO CHARENTE  LIMOUSINE  EXCHANGE 

* New members joining after 1st September of any year can pay a reduced sum of only 7.50 Euros.

DATE

 

SIGNATURE

 

CHEQUE ENCLOSED

 

  PLEASE POST YOUR COMPLETED MEMBERSHIP FORM AND CHEQUE TO THE ABOVE ADDRESS

© 2008 Charente Limousine Exchange
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