Click Here to get a printout of this page
Application form for members  
 

Please fill out the form and return it :
- by e-mail: avni@afindia.org

- to the center:
Alliance Française de Bombay
Theosophy Hall 40, New Marine Lines
Bombay 400 020
Tel: 2203 61 87 / 2203 59 93 Fax: 2206 61 57

Surname   Miss Mrs. Mr.
 
Name  
 
Date of birth day / month / year  
 
Place of birth  
 
Nationality  
 
Residential Address  
 
Telephone Fax  
 
Office Address  
   
Telephone Fax  
     
E-mail  
( Please indicate where you wish to receive your magazine )
 
Registered no.  
     
I hereby certify the accuracy of the above details and acknowledge
the receipt of the rules and regulations of the Alliance françaises de Bombay.
     
     
    Signature of member  
       
       
       
    Signature of Director  
       
Proposed by two active members :    
  Name Signature  
1  
2  
       
Receipt No. Date Amount Valid upto
 
 
     

home | alliance françaises India | © 2001 alliance françaises all rights reserved.