Lid worden:

Ledenadministratie:
Femie de Jager-ten Berge

De Contributie bedraagt € 20,00 per jaar.
€ 30,00 voor ‘Dubbelleden’; dit zijn 2 leden woonachtig op hetzelfde adres.
Jeugdleden tot 21 jaar betalen € 5,00 per jaar.

Graag onderstaand je gegevens:

E-mail: 

Vul de huidige datum in: 

Initialen: 

Roepnaam: 

Voorvoegsel: 

Achternaam: 

Straatnaam + huisnr.: 

Postcode: 

Woonplaats: 

Telefoon: 

'06' nummer: 

Jeugdlid: 

Naam van dubbellid: 

Eventuele opmerkingen: 

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Wil je het lidmaatschap opzeggen: 'druk op deze link'