Alliance
Fran¨aise du Piedmont
Membership Form
Nom, Prˇnom/Last Name,
First Name:
Adresse/Address:
Tˇlˇphone Domicile/Home Phone:
Tˇlˇphone Bureau/Work Phone:
Courriel/E-mail address:
Pour une famille, nom du conjoint:
For a Family Membership, SpouseÕs
Name:
Noms et Ages des enfants (ChildrenÕs Names and Ages):
Passe-temps/Hobbies:
Occupation/Profession:
Quel jour prˇfˇrez vous pour nos reunion/Which days are more convenient for you to come to the
club meetings?
Circle one - le matin,
lÕapr¸s-midi, le soir ?
Voulez-vous figurer sur notre annuaire francophone?/Would you like to be included in our directory
francophone?
YES/OUI NO/NON