Adhesion Form Hello and welcome.To become a member of the association freeGuppY, please fill in the form below.Cheerfully! The association freeGuppY Boxes with * are compulsory I'd like to become a member of freeGuppY, the association users of the script "GuppY", governed by the 1901 French law on non-profit associations, whose aim it is to ensure the promotion and durability of the "GuppY" software and its values : I am * : Private : 15 €Company : 45 € Association : 30 € Title * : Mr Mrs Miss Logo (companies only): Surname * : First name * : Postal Address 1 * : Postal Address 2 : Postcode * : Town * : Country * : Email * : Login : Telephone : Fax : Mobile : ICQ, MSN, ... : ICQ MSN Other (specify) : Occupation : Date of Birth : I authorize the use of my name and/or my image for communication purpose by freeGuppY exclusively.* : Yes No I would like to become a member of the management committee of freeGuppy* : Yes No I would like to be involved the life of the association* : Yes No As (If button yes is ticked) : Website (whole URL, 3 max) : Remarks, suggestions, questions : Signature : The reception of your subscription fee stands for your signature and validates your subscription
