Alliance Française de la Péninsule de Monterey P.O. Box 3573

Alliance Française de la Péninsule de Monterey
P.O. Box 3573, Carmel 93921 California
http://www.afmonterey.org Fiche d’inscription 2016 ( ) Une personne …………………………………….……. $25.00 ( ) Famille ………………………………..………….……….. $40.00 ( ) Professeur de français ( K-­‐12)…………….….…. $15.00 (_) Paiement par PayPal*…………………….…….…. $ 1.00 ( ) Frais d’envoi par poste** ……………………… $5.00 ( ) Donation *** ………………………….…………….…. $ _______ Total: $_____________________________________ Mr./Mrs./Miss/Ms/Dr./Sans titre Nom: _________________________________________________________________________ Adresse: ______________________________________________________________________ Tél: ______________________________ e-­‐mail : _____________________________________ Acceptez-­‐vous d’avoir votre numéro de téléphone et votre adresse email publiés dans la liste annuelle? ( ) oui ( ) non Pouvez-­‐vous ….. ( ) offrir votre maison pour une activité ? ( ) aider l’hôtesse lors d’une réception ? ( ) aider les personnes qui ne conduisent pas ? ( ) suggestions ___________________________________________________________________ LIABILITY The Alliance Française de la Péninsule de Monterey, its Officers, members and hosts, cannot be held responsible for any damage or injury incurred at the time of the activities of the organization, including transportation to and from these activities. Acceptance of participation in these activities shall be deemed to be consent to these conditions by the participants. Each person in the membership should sign. (The guests you invite to these activities are bound by the same policy. Please inform them). Signature : ____________________________________ Signature : _______________________________________ Date : ________________________________________ Date : __________________________________________ Rédigez votre chèque à l’ordre de: Alliance Française de la Péninsule de Monterey Imprimez cette feuille et envoyez-­‐la accompagnée de votre chèque à l’adresse suivante: Chantal Bailey , Trésorière 15550 Weather Rock Way Salinas, CA 93908 * PAYPAL – Nous offrons à nos membres la possibilité de payer par PayPal en utilisant la fiche d’inscription sur notre site web. ** CORRESPONDANCE : Normalement le courriel est utilisé en raison de son efficacité, de son impact environnemental réduit et du moindre coût. Cependant, malgré ces avantages, certains membres préfèrent utiliser l’envoie par courrier (USPS) Dans ce cas nous demandons un supplément de 5,00 $ par année pour couvrir les frais. *** DONATIONS: Aucun bien et services n’est offert en contrepartie d’une donation. L’Aliance Française de la Péninsule de Monterey est une association à but non-­‐lucratif 501 © (3), Tax ID 94. Nous comptons sur la générosité de nos membres pour enrichir la caisse des bourses. Ces dons permettent à l’Alliance Française de la Péninsule de Monterey de venir en aide à des professeurs ou à des étudiants avides de poursuivre leur étude de la langue et de la culture française. Alliance Française de la Péninsule de Monterey
P.O. Box 3573, Carmel 93921 California
http://www.afmonterey.org Membership Form 2016 (_) One person …………………………………………………………..…. $25.00 (_) Family …………………………………………………………….…….…. $40.00 (_) Teacher of French ( K-­‐12)……………………………….…….….. $15.00 (_) Payment via PayPal* …….…………………………………..….…. $ 1.00 (_) Correspondence via US mail rather than via email**…$5.00 (_) Donation *** ………………………….….……………………………. $ ____ Total: $___________________________ Mr./Mrs./Miss/Ms/Dr./No title Name: _____________________________________________________________________ Address: ___________________________________________________________________ e-­‐mail: ________________________________________ Tel: _________________________ Do you accept to have your phone & e-­‐mail published in the yearly roster? ( ) yes ( ) no Are you willing to .… (_) Provide your home for event? (_) Help the hostess at a reception? (_) Help people who do not drive? (_) Suggestions: ____________________________________________________________________________ LIABILITY The Alliance Française de la Péninsule de Monterey, its Officers, members and hosts, cannot be held responsible for any damage or injury incurred at the time of the activities of the organization, including transportation to and from these activities. Acceptance of participation in these activities shall be deemed to be consent to these conditions by the participants. Each person in the membership should sign. (The guests you invite to these activities are bound by the same policy. Please inform them). Signature____________________________________ Signature: ____________________________________ Date: _______________________________________ Date: ________________________________________ Write your check to the order of: Alliance Française de la Péninsule de Monterey Send this printed sheet and your check to the following address: Chantal Bailey, Treasurer 15550 Weather Rock Way Salinas, CA 93908 * PAYPAL – We offer our members to option of paying via PayPal when subscribing or renewing with the online membership form. ** CORRESPONDENCE: Normally email is used due to its efficiency, reduced environmental impact and less cost. However, in spite of those benefits sometimes members prefer to use regular (USPS) mail and for that we request an additional $5.00 per year to defray expenses. *** DONATIONS: No goods or services were provided in consideration for this gift. The Alliance Française de la Péninsule de Monterey is a non-­‐profit 501 © (3) organization Tax ID 94. We rely on the generosity of our members to enrich the scholarship fund. These donations allow the Alliance Française de la Péninsule de Monterey to help teachers or avid students to continue their study of the French language and culture.