Membership achievement to the Association Pro Elisarion

Yes, I/we hereby declare my/our membership in the association Pro Elisarion

Member as

Annual fee

Single person

Fr.

90.–

€

75.–

Student

Fr.

30.–

€

25.–

Couple

Fr.

150.–

€

125.–

Company/organization

Fr.

250.–

€

210.–

*First name

*Last name

*First name partner

*Last name partner

*Company/organization

*Address

Address supplement

*Postal code

*Place

*E-mail

Telephone

Comments

Application form

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