Les membres : FORMULAIRE POUR DEVENIR MEMBRE

Posté par Jacdesterres le 23/08/2011 15:10:00 (1708 lectures) Articles du même auteur

Association des collectionneurs de céramique du Québec

Formulaire d’inscription 2012

Vous pouvez d'ores et déjà payer votre cotisation annuelle 2012 (telle qu'établie à l'assemblée annuelle), soit 30$ membre individuel ou 30$ membres associés (résidant à la même adresse) ou familial, 30$ membre institutionnel. Vous pouvez payer votre cotisation à une de nos rencontres 2012. Si vous désirez recevoir votre CÉRAMAG par la poste, nous faire parvenir votre cotisation à l’adresse suivante avec ce formulaire :
(chèque au nom de l’Association des Collectionneurs de Céramique du Québec)

J. B. Dion, ACCQ,
C.P. 36512,
598, Victoria,
Saint-Lambert, Qc
J4P 3S8

Prénom : _____________________________ Nom : _____________________________

Prénom du conjoint(e) : _______________________ Nom du conjoint(e) : ___________________________

Institution : _______________________________

Adresse : _____________________________

_____________________________

_____________________________

Numéro de téléphone #1 :______________________ Numéro de téléphone #2 : ______________________

Courriel : ___________________________________

Je désire que mon nom et adresse de courriel soient publiés dans un bottin pour les membres de l’association
Oui ____ Non _____


Signature ______________________________


Pour faciliter la communication veuillez nous donner votre courriel si vous ne l’avez pas déjà fait : ceci dans le but de vous transmettre facilement des nouvelles de votre association. Si vous désirez que votre courriel reste confidentiel nous en aviser mais, dans tous les cas, vos informations personnelles ne seront pas transmises à des tiers.
Votre abonnement vous donne droit de participer aux encans et de recevoir notre publication (CÉRAMAG) en plus de vous donner droit de vote et de participation à toutes les activités de l’ACCQ (conférences, visites de Musées, etc.).
En espérant que vous pourrez appuyer l’association.
Merci à l’avance,
Jacqueline Beaudry Dion, présidente de l’ACCQ,
Cellulaire : 514-972-3466
Courriel : jbdion@gmail.com

À noter :Il est entendu que le bris de pièces présentées à nos rencontres lors de manipulation par les membres doit être remboursé par celui qui a occasionné ce bris (au prix de réserve pour les pièces à l’encan et à un prix déterminé par un comité de 3 membres du conseil d’administration pour les autres).



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