Application for C-E-U-S membership

	I hereby apply for membership with C-E-U-S. Membership can be terminated by letter every month. Membership fee is 2,50 Euro per month.
	Mrs. Mr.
Christian Name:
Family Name:
Occupation
Street
ZIP:
City:
Country:
Fon:
Fax:
e-mail:
Yes	I will pay an extra donation of Euro per month.
No	I only pay the regular membership fee.
	This application is valid without signature when sent.
	After filing you will receive a letter of confirmation with our bank account.