To become a voluntary helper


To join the association


Membership form
You can print this page and send it filled to us with an eight-euros cheque at the following address:

Association Audrey,

31, mail des Quatre Vents

49 000 Ecouflant

FRANCE


Membership form (renewable each year in January).


Name:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

First name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Post-code: _ _ _ _ _ _ _ _ _ _ _ _ _ _Town: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Phone number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Email:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _


Amount of your joining: 8 €


The way I pay:

V      Cheque

V      Cash

I also want to do a donation to Association Audrey whose amount is:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _


Date:                                                  Signature:



V      I want to receive a receipt corresponding to the given amount.