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Please print the form below and send it to : Melle Valérie BACON "Les Amis du Bobtail" Chemin de Gantuel 31590 SAINT-MARCEL PAULEL FRANCE |
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O Miss O Mrs O Mr
Name, First Name : ___________________________________________
Address : ________________________________________________________________
Postal Code : ________________________ City : ________________________________
Country : ______________________ Phone : __________________
How many O E S ? : ________________ Affix : ________________________________________________________
Annual Contribution :
O Member : 15 Euros
Please send me my membership card "Amis du Bobtail" for the year:_________
Signature :
