ICKL MEMBERSHIP

Payment with PayPal (in Euros)

Please make sure you fill all the fields. We are regularly updating our membership database and we appreciate to have all members’data again.

We ask that you renew your membership and provide payment before April 15, 2020. 

Name	First Name	
Address		
		
City, Zip Code, 	Country	
E-Mail	Phone #	
Nationality	Year of Birth	
Profession/Affiliation		
Date	

Check as appropriate 

MEMBERSHIP 2020

O	Regular fee 1 Year	45 Euros

O	Student fee* 1 Year	32 Euros

* Student - please enclose a copy of your current student ID

Payment 

O	I have paid online with PayPal. Date of the transaction	

Form to return to Treasurer Europe
	Béatrice AUBERT 
	Email: treasurer-europe@ickl.org