Subscription for 2010

Subscription received after 1st November will automatically be carried over to the following year.
You will receive, in addition, the last edition of the current year’s magazine.
 

I wish to belong to the Natinal Association and local Branch . . . . . . . . . . Membership . . . . . 50 € ___________
And I wish to receive 4 editions of the current year’s magazine  . . . . . . . . . . . Couple . . . . . 54 € ___________
(membership 25€ or 28€ + magazine 21€)                                 
To subscribe to a second Department add a supplement of . . . . . . . . . Membership . . . . . . 14€ ___________

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Couple . . . . . . .16€ ___________
                                                  

Subscription without magazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Membership . . . . . . . 28€ ___________
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Couple . . . . . . . 32€ ___________
                

I wish to receive only the magazine (without subscription) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36€ __________
magazine if abroad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Plus . . . . . . . . 8€___________ 
 
 

Donations to the Association . . . . . . . . . . . . . . . . . . . . For the National Association : ____________
. . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For my Department : ___________         

(A tax receipt will be sent) 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL ____________€ 
    

Mr - Mrs - Miss ** . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name :

Current - New subscriber **. . . . . . . . . . . . . . . . . . . . .Forename :

Profession :      

2nd name for a couple subscripbing : . . . . . . . . . . . . . . . .Name : 
Mr - Mrs - Miss **. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Forename : 
Profession :   
      

Tel : _ _  _ _  _ _  _ _   _ _  . . . . . . . . . Adress :

Fax : _ _  _ _  _ _  _ _  _ _ . . . . . . .Postal code:  
     

E-mail :___________________________Town : 

Chosen Department : __________________________Your address in this Department :  
   

Department of second affiliation:      
     
 

I heard about the Association by:     
 

Date : ____________________________Signature :  


  Completed form and cheque made out to Maisons Paysannes de France to be sent to MPF: 8 passage 
des Deux Soeurs, 75009 Paris.
  or to Mme Madeleine Audebrand 19 rue du calvaire 79160 Coulonges/l’autize

  In accordance with Article 27 of the data processing law, you have the right of access and of correction of the information concerning yourself, of which we are the sole recipients.

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