MEMBERSHIP APPLICATION FORM FOR LE BRIQUET

 

Until we can process membership applications "on line", we kindly ask you to fill in the form below, print it and send it back to:

Le Briquet
2, Cloître Saint-Pierre-le-Puellier
F - 45000 Orléans

l The total membership fee for the year 2008 is 44,00 € (1 € for membership and 43 € for subscription to the bulletin).

l Junior members (less than 18 years of age) pay half-price: 22,00 €.

l For members who reside abroad, we accept only payment by International Postal Transfer (account detail: CCP 1016-42 W La Source) or check in euros collected in France. An additional 9,50 € is required for air mail processing.

 Surname First Name
Lieu-dit
N° Street
Country Postal code City
Telephone (optional) E-mail
Date of birth (junior members only)
Activity (optional)

These information are provided for an automated processing registered under #144474 by the Commission Nationale de l'Informatique et des libertés (National Commission on Data Processing and Individual rights), as per the law of January 6th 1978 which grants a right of access and modification to this data if required by the provider.

Area of interest (rank from 1 to 5 in decreasing order of preference):

Flats Solid figures Documentation Militaria Wargame

Other(s)

Period of interest (rank from 1 to 9 in decreasing order of preference):

Ancient Medieval 17th/18th century Napoleonic

1820-1850 2nd Empire WW1 WW2 Contemporary

Payment of year 2008 fee as follows

Active member....................................... :

44,00 €

Benefactor minimum is...... :

66,00 €

Junior member.................................... :

22,00 €

airmail handling fee for abroad.... :

9,50 €

TOTAL:

For members who reside abroad, we accept ONLY payment by check in euros collected in France
or International Transfer with account detail below:

Compte chèque postal n° 1016-42 W - Centre d'Orléans-La Source

IBAN

FR5620041010120101642W03366

BIC

PSSTFRPPSCE


For complement information, please contact our association on : briquet@histofig.com

To read our statute (in French): please, click here.

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