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