Name

First name

Adress

E-mail address

Telephone

I ask to become a member of the A.S.B.L. "COMMANDO MUSEUM – MUSEUM DER COMMANDO'S"

I am (former) Commando. I serve / I served (Unit and period) :

Réponse au champ précédent

I pay today the sum of 10.00€ for contribution to account BE55. 0012. 8958. 0644 of "MUSEE DES COMMANDOS - MUSEUM DER COMMANDO’S" A.S.B.L. Barracks SLt THIBAUT, 5020 FLAWINNE.

Date

For approval For approval For approval