BULLETINS  A IMPRIMER   UN   ORIGINAL  + UN DOUBLE

 

                                                                                     EOLINFO                                 Le .......................                                                   
                                    BULLETIN D ADHESION A KIPROKO Association affiliee a VENT DE COLERE 

 
      NOM…………………………………………………..…………………… ADRESSE…………………………………………………..……………..

       VILLE……………………………….……. DEPT………………………. CODE POSTAL………….… TELEPHONE…………….……………...   


                                                                            E MAIL………………..
__________________________________________________________________________________________________________________________ 
                Ci-joint cheque montant 10€ cotisation pour l annee en cours ΰ l ordre de
                                                                                  Jean Menard pour ASSOCIATION KIPROKO (site EOLINFO)
                                                                        A l adresse de Jean Menard 3 Rue d’Aumale 75009 Paris
 

 


 

                                                                                     EOLINFO                                 Le .......................                                                   
                                    BULLETIN D ADHESION A KIPROKO Association affiliee a VENT DE COLERE 

 
      NOM…………………………………………………..…………………… ADRESSE…………………………………………………..……………..

       VILLE……………………………….……. DEPT………………………. CODE POSTAL………….… TELEPHONE…………….……………...   


                                                                            E MAIL………………..
__________________________________________________________________________________________________________________________ 
                Ci-joint cheque montant 10€ cotisation pour l annee en cours ΰ l ordre de
                                                                                  Jean Menard pour ASSOCIATION KIPROKO (site EOLINFO)
                                                                        A l adresse de Jean Menard 3 Rue d’Aumale 75009 Paris