Regular members form - Alliance Française de Hong Kong

MEMBERSHIP FORM
Ordinary member
PLEASE WRITE IN BLOCK CAPITALS
Please do not fill in this part
 Hong Kong ID#
 Title:
M.
Mrs.
Miss.
Ms.
 AFHK number
 Surname in English - (as printed on HKID):
 Expiration date:
 First name in English - (as printed on HKID):
 Reader Number
 Date of Birth - (dd/mm/yy):
 Nationality:
 Phone:
 E-mail
Would you like to receive “La Bulle”, our e-newsletter about cultural activities and courses?
 Yes  No
 Address :
flat/room
block
floor
name of building
District
Number & name of street/estate
 I would like to become a member of the Alliance française de Hong Kong and pay an annual subscription
fee of HK$300. As such, I’ll be able to borrow documents at the Mediatheque with the Alliance française de
Hong Kong Card.
 I have read and accepted the general conditions of the library
Date:
Signature:
OFFICIAL USE ONLY
Cotisation:
Versée le
Montant
Chèque nº
Reçu nº
Date d’expiration