GSCL FORM4 - Gaelic Sports Club Luxembourg

GAELIC SPORTS CLUB LUXEMBOURG ASBL
AFFILIATED TO THE CERCLE SPORTIF DE L'UNION EUROPÉENNE AND
THE FÉDÉRATION LUXEMBOURGEOISE DES SPORTS GAÉLIQUES ASBL
Thank you for becoming a member or for renewing your membership of Gaelic Sport Club Luxembourg asbl.
Please transfer your annual subscription fee to the Club's Bank Account. We need your information for our own
records and to register your membership with the GAA and with the Cercle Sportif. Complete this form, save it and
send it to [email protected].
Imreoir / Playing member / Joueur (euse)
€75
Mac léinn / Student member / étudiant (e)
€25
IBAN: LU24 0021 1375 5690 0000
Gnáthbhall / Non-playing member / Non-joueur (euse)
€60
BIC: BILLLULL, Dexia
Gaelic Sports Club Luxembourg
Tá suim agam sna foirne seo a leanas/I am interested in playing/Je voudrais jouer…
Iomáint/Camóige
Peil/Football/Football gaélique
Sacar laistigh/indoor football/
Foot en salle
Tá na sonraí seo uainn le do bhallraíocht a chlárú leis an gCLG/We need the following details to
register your membership with the GAA/ Nous avons besoin des détails suivants pour enregistrer
votre adhésion avec la GAA.
Ainm / Name / Nom
Sloinne / Surname / Nom de famille
Postchód / Postcode
Seoladh / Address / Adresse
Baile / Town / Ville
Dáta Breithe/Date of Birth/Date de naissance
(Riachtanach d'Imreoirí/Required for playing members/ Obligatoire pour les joueurs)
Have you ever been a member of any other GAA club?:
Ainm an chlub / Club name / Nom du club
Contae/County/Comté
We're affiliated with the Cercle sportif de l'Union Européene. Please let us know if you work for one of the
EU Institutions or agencies or for the European School and complete the following section of the form.
Institiúid / Institution
Seoladh oifige / Office address / Bureau
Ríomhphoist oibre / Work email / E-mail professionnelle
We want to keep in touch with all of our members, please give us your email addresses and contact telephone numbers.
Ríomhphoist / e-mail
Uimhir theileafóin / Telephone number / Numéro de téléphone
E GROUSSE MERCI FIR AER ENNERSTËTZUNG / UN GRAND MERCI POUR VOTRE SOUTIEN / GO RAIBH MÍLE MAITH AGAT AS UCHT DO THACAÍOCHT
WWW.LUXGAA.LU