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Member

My schedule does not allow me to make time for the association. However, I would like to contribute and keep myself informed of the association's news.

Terms:

25€ / Year

First Name:* First Name Required

Last Name:* Last Name Required

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Phone:* Telephone is Required

Date of birth: Date of birth is not valid

Occupation:* Profession is Required

How did I find out about the Association?:* How did I find out about the Association? is Required

Membership type:* Membership Type is Required

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Description	Amount
Member – Initial Payment	25.00€
Total	25.00€

Select Payment Method

Secure payment By transfer By cheque

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IBAN:
FR76 1780 7000 0245 4193 9194 121

BIC:
CCBPFRPPTLS

payable to: L’ASPIC

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