Please complete this form in clear print and mail it together with your payment (cheque not cash) to: The Membership Officer, Alliance Française de la Côte de Saphir, P. O. Box 3, MERIMBULA 2548
Alliance Française RENEWAL/ NEW (Please circle one) MEMBERSHIP APPLICATION for 2011
NAME/S………………………………………………………………
ADDRESS ……………………………………………………
POSTCODE ………….
TELEPHONE ……………........…………
E-MAIL ……………………………………….............…
SUBSCRIPTION (Please circle one) FAMILY $40 SINGLE $ 25 SCHOOL $ 25
I WILL BE ATTENDINGCLASSES YES / NO(Please circle one)
Please note that, unless otherwise requested, "La Mouette", our monthly newsletter, will be delivered by email in order to reduce costs. Please be sure that your email address is printed CLEARLY and that it is current.
Thanks,
Neil Porter
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