Union des Franç BULLETIN D`ADHESION Union des Français de l

Union des Français de l’Etranger
Victoria Australia
BULLETIN D’ADHESION – 2013 / MEMBERSHIP FORM – 2013
Nom / Surname: __________________________________________________
_________________________________________________________
_________________
Prénom / First name: _________________________________________
______________________________________________________________
___________
Profession - Entreprise / Job title - Company:
Company _____________________________________
____________
__________________________________________________________________________________
Adresse professionnelle / Business address:
address _________________________________________
______________
_________________________________________________________
________________________________________________________________________
______________________
Tel.: _______________
/_________________ Courriel / e-mail: _____________________________
______________________
Adresse postale / Postal address: ____________________________________________________
____
_____________
__________________________________________________________________________________
_____________________________________________________________________________
Autres membres adhérents / Other
ther members:
member
___________________________________________________________
__________________________________________________________________________________
____________
____________________________________________________________
__________________________________________________________________________________
___________
Je souhaite adhérer à l’UFE et recevoir la revue bimestrielle « Voix de France » / I would like to join UFE and
receive the bimestrial
trial magazine “Voix de France”.
France”
Signature : _______________________
___ / ___ / _____
Statut adhérent / Membership
embership status:
status
Adhésion simple / Single
ingle membership – $80
Adhésion couple / Membership
embership for couples – $120
Adhésion étudiant / Student membership – $50
Règlement de ma cotisation / Membership fee payment:
En espèces / By cash
Par chèque à l’ordre de / By cheque adressed to: UFE Victoria Australia
Par virement bancaire à / By Bank Transfer to :
UFE Victoria Australia – WESTPAC Toorak – BSB : 0033 086 – A/C: 396376
Le bulletin d’adhésion est à retourner à / The membership form needs to be returned to:
UFE VIC P.O. Box 333,
333 TOORAK 3142, VIC
Ou par email à / or by email at [email protected]
UNION DES FRANCAIS DE L’ETRANGER VICTORIA AUSTRALIA INC. A0059138L
Associations
ssociations Incorporation Reform Act 2012 Section 8
0412 238 750 [email protected]