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Membership form

Steven's Association Moonrise A.S.B.L.

 

 

Application for Membership

 

Name:

 

Address:

 

E-mail address:

 

Contact details:

 

Signature:

 

By joining Steven's Association Moonrise A.S.B.L., I undertake to comply with the statutes of the ASBL and to support its aims.

 

 

ANNUAL SUBSCRIPTION FOR 2012 – € 25

                                  

Annual subscription of € 25 per adult member to be paid by bank transfer to:

Steven's Association Moonrise A.S.B.L.:

IBAN Bank Account Number BE38 8637 1338 2472
BIC SPAABE22 
 
stating clearly your name and “Steven's Association Moonrise ASBL Membership 2012”.